Q: What are the pros and cons of jaw surgery?

Pros Orthognathic surgery can boost self-esteem and provide comfort after years of pain and insecurity. It can fix major orthodontic issues that braces and less invasive forms of adjustment can’t. Though follow-up adjustment and care is necessary, the results are permanent. It can provide a solution to chewing issues, speech impediments, and breathing problems like sleep apnea. Cons Recovery is long and uncomfortable and requires a month of downtime. Possibly complications include nerve damage or damage to teeth and bones.

Question 1

What is jaw surgery?

Accepted Answer

Corrective jaw surgery, also called orthognathic surgery, can resolve a range of conditions that affect the jaw, face, and teeth by moving the jaw into a new position that provides better alignment. The procedure is usually performed by a board-certified oral and maxillofacial surgeon.

“Misaligned jaws can affect function and airway and contribute to facial aesthetic deformities, such as asymmetry, high-angle mandible [steep jawline], vertical maxillary excess [overgrowth that results in a gummy smile], open bite, overbite, and underbite," explains New York City oral and maxillofacial surgeon Dr. Majid Jamali. "The muscles of the face and the temporomandibular joint [TMJ] may become sore, as a result of these conditions.”

Along with chronic joint pain, malocclusion (bite misalignment) can also cause functional problems, like speech issues or difficulty chewing.

A misaligned jaw can be the result of childhood trauma to the face or chin, benign lesions, or birth defects or caused by a bone disease called condylar hyperplasia.

Repositioning your jaw alignment can dramatically change your facial appearance, offering a self-esteem boost and making it easier to chew, speak, and even sleep (by resolving obstructive sleep apnea).

Orthognathic surgery (and any type of oral and maxillofacial surgery) should be performed only on adults with good oral health and fully developed bones.

Question 2

What are the pros and cons of jaw surgery?

Accepted Answer

Pros

Orthognathic surgery can boost self-esteem and provide comfort after years of pain and insecurity.
It can fix major orthodontic issues that braces and less invasive forms of adjustment can’t.
Though follow-up adjustment and care is necessary, the results are permanent.
It can provide a solution to chewing issues, speech impediments, and breathing problems like sleep apnea.

Cons

Recovery is long and uncomfortable and requires a month of downtime.
Possibly complications include nerve damage or damage to teeth and bones.

Question 3

How much does orthognathic surgery cost?

Accepted Answer

Jaw surgery cost will depend on your surgeon’s level of experience, their practice location, and the details of your surgery. Some RealSelf members have reported paying more than $50,000 for complicated corrective jaw surgery.

The good news is that this surgery is covered by most medical insurance plans. “Your surgeon's office will assist you in getting pre-authorization from the insurance company four to six weeks prior to surgery,” says Dr. Jamali.

You can finance your treatment with CareCredit.

See our complete guide to jaw surgery costs

Question 4

Jaw surgery before and after pictures

Accepted Answer

The jaw surgery photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

How do you prepare for jaw surgery?

Accepted Answer

Most patients start with an orthodontic treatment, like braces or Invisalign, to align the dental arches, says Dr. Jamali. This process can take anywhere from six months to three years, depending on the state of your teeth and gums.

“Once this phase is complete, the patient is seen again by the oral surgeon,” says Dr. Jamali. “During that appointment, impressions of the teeth are taken, along with X-rays and photos.”

You'll also need to have wisdom teeth removal (if you haven't already), to prevent complications.

To prepare for your post-surgery diet, stock up on liquids and foods that can easily be liquefied, since you will not be able to chew for six weeks post-surgery.

“For 10 days prior to surgery, patients should also avoid herbal medication, fish oil, NSAIDs, and vitamins,” says Dr. Jamali. Post-op antibiotics and pain medication are prescribed prior to surgery, so you'll have them when you come home.

Question 6

What happens during jaw surgery?

Accepted Answer

Your surgery will be done in a hospital or an outpatient oral surgery center. You'll be placed under general anesthesia before your surgeon makes bone cuts (osteotomy) in your upper jaw (maxilla) and/or lower jaw (mandible) and moves them into the ideal position for your bite.

During upper jaw surgery, incisions are made under the eye sockets to allow the jaw, roof of your mouth, and teeth to move into alignment together. For lower jaw surgery, cuts made lengthwise and behind the molars allow the jaw, soft tissue of the palate, and lower teeth to move into their new position as one unit. In rare cases, bone may be taken from the hip, leg, or rib and used to lengthen the jaw.

Once your jaw is in position, your surgeon will use tiny plates and titanium screws to fix the bones in place. These screws will fuse to the bone over the next four months, becoming a permanent part of your jaw.

After surgery, most patients need to stay overnight for monitoring, and some need an extra day or two before heading home.

Question 7

How long does orthognathic surgery take?

Accepted Answer

Depending on the extent of correction and structures involved, jaw surgery can take anywhere from three to five hours or more.

Question 8

What can you expect during orthognathic surgery recovery?

Accepted Answer

Plan on taking two weeks off from work, at a minimum. If your surgery is more involved or you’re slow to heal, you may need to stay home for up to six weeks.

“The first week after surgery is the most difficult,” says Dr. Jamali. The sinuses fill with fluid, making it difficult to breathe through your nose. Still, he says, patients typically find recovery to be more uncomfortable than painful.

Related: I Got Double Jaw Surgery, and the Recovery Was Brutal

You will have swelling, bruising, and tenderness around your jaw, and you may see bruising on your neck and chest. Your doctor will prescribe painkillers, to keep you more comfortable.

“Bone takes five to six months to fully heal. A liquid diet is suggested for the first six weeks, followed by six weeks of soft foods,” says Dr. Jamali. He doesn’t wire teeth shut during recovery, but many surgeons do.

Once your surgeon allows it, you can start adding soft foods (like mashed potatoes and pasta) to your diet. Fluids are also an important part of your recovery, since staying hydrated helps the body heal.

Avoid contact sports and rigorous activities for a few months, since your jaw can shift if it’s bumped or hit.

Plan for follow-up visits with your surgeon at one, four, and six weeks so that your surgeon can monitor the progress of your healing.

Question 9

When will you see results, and how long will they last?

Accepted Answer

Your face may look different right after the surgery, since even subtle changes to jaw positioning can alter appearance. However, you’ll need to wait six weeks for the initial swelling to subside and another few months for the jaw to mostly heal before you can see your results. You could have braces for 6 to 12 months following surgery too.

Corrective jaw surgery is generally long-lasting. Your orthodontist and surgeon will monitor your post-op progress, to make sure your teeth and jaw align as you recover.

Some people need jaw surgery revision, if they still have problems with bite and alignment or the jawbone reverts to its former position over time.

Even if the surgery is a technical success, some seek revision because they’re unhappy with how their new jaw position has altered their appearance (which is why doctors recommend waiting until the jaw has completely formed before operating—anywhere from the mid-teens for women to the early 20s for men).

Chin surgery (genioplasty or mentoplasty) can be performed after you've healed, to augment your chin and give you a more defined jawline.

Question 10

What are the risks and potential side effects of orthognathic surgery?

Accepted Answer

Although it can be complicated, jaw surgery is generally considered safe when done by an experienced surgeon who works with your orthodontist to ensure the best results. As with any surgery, there’s the potential for side effects such as bleeding, infection, and numbness.

Because the nerves in your mouth are stretched during surgery, you may experience numbness in your lips, gums, and lower face as you heal. This is normal, and feeling typically returns within a few months.

“Rare risks include damage to teeth, relapse, failure of the hardware, and TMJ issues,” says Dr. Jamali; all of these may contribute to the need for revision surgery.

Question 11

What are the alternatives to orthognathic surgery?

Accepted Answer

If your main reason for considering jaw surgery is to change your appearance, there may be less invasive options that have far less downtime.

The shape of your chin could be changed by having a procedure called sliding genioplasty or by using implants or injectable fillers, such as Juvéderm Voluma, which is FDA-approved for chin augmentation.

If your jaw issues aren’t severe, your orthodontist might be able to change the look of a jutting jaw by removing molars and then using braces to shift your front teeth inward. This can be done only in cases of mild facial or dental disharmonies, notes Dr. Jamali.

You can also augment a recessed chin with a sliding genioplasty or a chin implant.

JAW SURGERY

Majid Jamali, DMD

Julie Ricevuto

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Majid Jamali, DMD

Julie Ricevuto

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