Jaw surgery, also known as orthognathic or orthofacial surgery, corrects irregularities of the jaw bones and realigns the jaws to improve facial appearance and position of teeth.
Jaw surgery may be a corrective option if you have jaw problems that can’t be resolved with orthodontics alone. It is also used to improve facial profile or improve breathing by patients with obstructive sleep apnea syndrome. In most cases, you also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with maxillofacial surgeon to determine your treatment plan.
Jaw surgery is appropriate after growth stops, usually around ages 17 to 18 years for females and ages 18 to 21 years for males.
There are 3 main types of surgery. Upper jaw, lower jaw or combination also called bimaxillary surgery.
Description
Lower jaw surgery (Bilateral Sagittal Split Osteotomy)
The surgery is in general anaesthesia. An opening is made inside the mouth on the jaw just behind and to the side of your last teeth of your lower jaw. This opening will be about 4-5 cm long and the resulting scar will be within the mouth.
The back part of the jaw, which is behind and under the rearmost teeth, will be accessed through this opening. This is the part of the jaw which will be separated. A cut is made along the top and side edges of the jaw. The purpose of these cuts is to separate the jaw in such a way that will create a broad overlap of bone between the cut surfaces.
Through the cut bone edges, bone separators called “osteotomes” are used to split the jaw. Once the bones are separated on both sides they are moved into their new position. The lower jaw is securely fixed into its new position using screws or a combination of plates and screws which are inserted over a small tunnel. The openings within the mouth are then closed with stitches that will slowly dissolve. Sometimes there will be one stich also on the skin.
Upper jaw surgery (LeFort 1)
The surgery is in general anaesthesia. An opening is made inside of the mouth close to where the upper lip meets the gums. The opening is form left to right first molar and the resulting scar will be completely hidden inside the mouth. Through this opening, the upper jaw will be accessed, separated and repositioned by bringing it in the new position. The upper jaw is then securely fixed to its new position using a combination of plates and screws. The opening inside the mouth is then closed using stitches that will slowly dissolve.
Bimaxillary or double jaw surgery
The surgery is in general anaesthesia and is a combination of the lower and upper surgery.
Postoperative recovery
- Day 1-3: Hospital stay, cold compressions, soft food diet, guiding elastics, control x-rays. Most of the discomfort that you will experience after the surgery will be from the swelling of the face rather than the pain from the surgery itself. You will receive medicine to help with discomfort.
- Week 1: Check-up.
- Week 2: Decrease of swelling and bruising.
- Week 6-8: Normal food diet.
Additional information
It is very important to listen to the surgeon’s and orthodontist’s directions regarding the types of foods you can eat following the surgery and when it is safe to eat them. Eating appropriate foods will help with the healing, but eating hard foods too early can damage the surgery. As the swelling subsides, you will be able to move the jaw to a greater degree. Your orthodontic care will continue after surgery. This can take form of a rubber band therapy to help guide the lower jaw into the upper jaw. Braces may also continue for several months after the surgery. Speak to your orthodontist to find out your treatment plan.