Jaw Surgery

Jaw surgery, or orthognathic surgery, changes the shape of your jawbone so your upper and lower jaws line up as they should. Healthcare providers may call this procedure corrective jaw surgery. You may have this procedure if you have:

• Broken jaws
• Cleft lip and palate
• Jaw cancer
• Jaw cysts and tumors
• Malocclusion (including overbite, overjet and underbite)
• Obstructive sleep apnea (OSA)
• Prognathism (when one or both of your jaws stick out)
• TMJ (temporomandibular joint) disorders
• Undersized or oversized jaws

Your surgeon may recommend that you wait until your jaw has stopped growing before you have surgery for issues like malocclusion.

Orthognathic (pronounced “or-thuh-NA-tuhk”) surgery combines surgery and orthodontic treatments over a two- to three-year period. The process involves:

• Orthodontic treatment to prepare your teeth
• Surgery to line up your upper and lower jaws
• Follow-up orthodontic treatment to help move your teeth into place

Types of jaw surgery

There are several types of surgery:

• Maxilla surgery (maxillary osteotomy): You may have this procedure if your upper jaw sticks out too much or too little.
• Mandible surgery (mandibular osteotomy): This procedure treats lower jaws that stick out too far or too little.
• Double jaw surgery (bimaxillary osteotomy): You may have this procedure if there are issues with your upper and lower jaw.
• Genioplasty (chin surgery): This surgery changes the shape or size of your chin. You may have this procedure as part of your orthognathic surgery.

Orthognathic surgery benefits and risks

The procedures can fix issues that nonsurgical treatments can’t. For example, braces can move your teeth into new positions. But they can’t move your jaw or change its shape.

Like any major surgery, these procedures come with potential complications, including:

• Heavy bleeding
• Reaction to anesthesia
• Infection

Jaw surgery may cause:

• Dental damage
• Difficulty opening your mouth as wide as you’d like
• Jaw pain
• Lingering numbness around your mouth after surgery

What happens during jaw surgery?

You’ll receive general anesthesia so you’re asleep during the procedure. What happens next varies depending on your situation. In general, during orthognathic surgery, your surgeon will:

1. Make incisions (cuts) to get to your jawbone. They may make the cuts inside your mouth or make one or two small cuts on your outer jaw.
2. Make small cuts in your jawbone.
3. Position your jaw.
4. Remove, reshape or add bone as needed.
5. Secure your jaw with surgical screws, wires or plates.
6. Close the cuts and cover them with bandages.
7. Place a splint over your teeth for stability.

It can take up to four to six hours to complete corrective jaw surgery.

Orthognathic surgery recovery

You may stay in the hospital for one to three days after your surgery. Your healthcare team will check that your jaw is healing as it should. They’ll also help manage surgery side effects, like:

• Bruising
• Swelling
• Stuffy nose
• Sore throat
• Pain and tenderness

These side effects should ease up after a week or two. But tell your surgeon if you have pain that doesn’t go away with medication.

Most people can return to their daily routine after three to four weeks. But jaw surgery recovery is a marathon, not a sprint. Your initial healing takes about six weeks. Your jaw will continue to heal for the next several months. It may be a year before your jaw heals completely.

Here are some tips for a smooth recovery:

• Ice your jaw. You’ll need to keep ice packs on your outer jaw over the first 24 hours. Apply the ice pack for 20 minutes on, 10 minutes off, and then repeat as needed.
• Take your meds. Your healthcare provider will prescribe medication to reduce your risk of pain and infection. Ask about getting your medications before surgery so you don’t need to stop at the pharmacy on the way home.
• Lift your head. Use pillows to prop up your head. This helps with swelling.
• Wear your splint. The splint helps your mouth muscles adjust to your jaw’s new position.
• Stick with smoothies. You may be on a liquid diet for the first few weeks after surgery. Ask your surgeon what nutrient-rich foods you can throw into a blender.
• See your orthodontist. If you have braces, you’ll have regular follow-up appointments until the braces come off.
• Wear your retainer. After your braces come off, you’ll need to wear a retainer to keep your teeth in their new places.

When should I call my healthcare provider?

Call your surgeon right away if you have:

• A fever higher than 100.4 degrees Fahrenheit (38.3 degrees Celsius)
• Pus or discharge from the incisions
• Pain that gets worse
• Shortness of breath
• Vomiting or diarrhea that doesn’t go away

Is orthognathic surgery successful?

Research shows that between 83% and 100% of people who had orthognathic surgery were satisfied with the outcome. People had an improved quality of life.