Jaw Surgery

Jaw surgery, also known as orthognathic surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance.
Jaw surgery is appropriate after growth stops, usually around ages 14 to 16 years for females and ages 17 to 21 years for males.

When to Consider Jaw surgery

– Make biting and chewing easier and improve chewing overall
– Correct problems with swallowing or speech
– Minimize excessive wear and breakdown of the teeth
– Correct bite fit or jaw closure issues, such as when the molars touch but the front teeth don’t touch (open bite)
– Correct facial imbalance (asymmetry), such as small chins, underbites, overbites and crossbites
– Improve the ability of the lips to fully close comfortably
– Relieve pain caused by temporomandibular joint (TMJ) disorder and other jaw problems
– Repair facial injury or birth defects
– Provide relief for obstructive sleep apnea

How is a lip enhancement procedure performed?

Surgery is usually done under general anesthesia. Surgery takes place in the hospital and requires a two- to four-day stay.
Surgery usually can be performed inside your mouth, so no facial scars show on your chin, jaw or around the mouth. However, sometimes small incisions may be required outside your mouth.
Your surgeon makes cuts in the jawbones and moves them into the correct position. Once your jaw movement is completed, tiny bone plates, screws, wires and rubber bands may be used to secure the bones into their new position. These screws — which are smaller than a bracket used for braces — become integrated into the bone structure over time.
In some cases, extra bone may be added to the jaw. Your surgeon transfers the bone from your hip, leg or rib and secures it with plates and screws. In other cases, bone may be reshaped to provide a better fit.
Jaw surgery may be performed on the upper jaw, lower jaw, chin or any combination of these.

Upper jaw (maxillary osteotomy)
Upper jaw surgery

Surgery on the upper jaw may be performed to correct:
– Significantly receded or protruding upper jaw
– Crossbite
– Too much or too little of the teeth showing
– Open bite
– Reduced facial growth of the middle of the face (midfacial hypoplasia)
Your surgeon cuts the bone above your teeth so that the entire top jaw — including the roof of your mouth and your upper teeth — can move as one unit. The jaw and upper teeth are moved forward until they fit properly with the lower teeth. This can be planned on a computer to determine if additional work, such as orthodontics, will be needed to help correct any remaining fit difference.
An open bite occurs when excess bone grows above the molars, causing what’s normally a flat, even surface to become angled. To fix this, your surgeon shaves away or removes the excess bone.
Once the jaw is realigned, plates and screws hold the bone in its new position.

Lower jaw (mandibular osteotomy)
Lower jaw surgery

A mandibular osteotomy can correct:
– Receding lower jaw
– Protruding lower jaw
The surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.

Chin surgery (genioplasty)
Chin surgery

A genioplasty can correct a small chin (deficient chin). A small chin often accompanies a severely receded lower jaw.
Typically, surgeons can alter the jaw and restructure the chin during the same surgery. The surgeon cuts a piece of the chin bone on the front of the jaw, moves it forward, and secures it in a new position with plates and screws.

How do I prepare for a lip enhancement procedure?

– Stop smoking at least six weeks before undergoing surgery to promote better healing
– Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding
– Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery

Aftercare and Recovery

After surgery, your doctor will provide you with instructions. These usually include:
– What you can eat
– Oral hygiene
– Avoiding tobacco
– Avoiding strenuous activity
– Medications to control pain
– When to return to work or school, which is usually in one to three weeks
Initial jaw healing typically takes about six weeks after surgery, but complete healing can take up to 12 weeks.
After initial jaw healing — at about six weeks — your doctor finishes aligning your teeth with braces. The entire orthodontic process, including surgery and braces, may take several years. Once the braces are removed, retainers to hold tooth position may be used.

How Long Will the Results Last?

Jaw surgery results are permanent.

Limitations and Risks

– Adverse reaction to anesthesia
– Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
– Infection
– Changes in sensation
– Scarring
– Allergic reactions
– Damage to underlying structures
– Unsatisfactory results that may necessitate additional procedures.
– Nerve injury
– Jaw fracture
– Relapse of the jaw to the original position
– Problems with bite fit and jaw joint pain
– Need for further surgery
– Need for root canal therapy on selected teeth
– Loss of a portion of the jaw