Is it better to have a nose job or jaw surgery first? (photos)

I have an open bite as well as a cross bite and an underdeveloped top jaw. For this, I will need extensive orthodontics followed by surgery, but currently cannot afford this. I also desperately want a nose job, and can afford that at this time. My question is: Would it be better to wait until after my jaw surgery to get a rhinoplasty? Or would it be safe to go ahead with the nose job now so I can gain confidence while saving for my jaw procedure? Thank you for any advice!!!

Doctor Answers 7

Nose job first or Jaw surgery?

I agree with the other physicians that generally it is better to have the jaw, or orthognathic, surgery first. This is particularly true if the upper jaw is going to be moved one way or the other.  If  you have at least had a consultation with the oral surgeon and know the game plan, you could always schedule an appointment with a plastic surgeon and get their opinion. If the main thing is the orthodontics, then maybe you could have the nose job first. 

Milwaukee Plastic Surgeon
4.8 out of 5 stars 30 reviews

Is it better to have a nose job or jaw surgery first?

As a general rule, it's always best to undergo the jaw surgery first and then proceed with the rhinoplasty. Over the last 25 years, we have performed rhinoplasty both before and after jaw surgery, so there always are always exceptions to the rule. Both procedures are rather difficult, so choose your surgeons very wisely based on extensive experience with the procedures.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Order of surgery

Thank you for the question and generally it is recommended to complete orthognathic surgery before proceeding with a rhinoplasty. Obviously though there are exceptions and an examination is needed.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

Rhinoplasty or Jaw Surgery...

Hello -

The nose and jaw are intimately related as it relates to providing balance to the overall face.  This is especially true on profile view.  Given that your jaw surgery will ultimately affect the profile I would pursue your orthognathic surgery first and your rhinoplasty second.  I don't think it is necessary to wait until the full orthodontic portion of the procedure is complete to have your rhinoplasty. 

Justin Wudel, MD
Edina Otolaryngologist
5.0 out of 5 stars 1 review

Rhinoplasty and jaw surgery

Hello and thank you for your question. The best advice you can receive is from an in-person consultation.   There are several options for this combination of surgery.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Rhinoplasty: timing with orthognathic (jaw) surgery

Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.

Orthognathic surgery is a surgery to adjust the jaw for improved contact between your teeth. 

I would recommend pursuing orthognathic surgery first. The nose is set in relationship to the position of the overall face, forehead, and jaw. In addition, if you had your nose surgery first, there is potential stress on the nose during the orthognathic surgery: a large breathing tube may be placed through your nose, or the nose may be pushed while manipulating the jaw. I suggest talking to both surgeons to coordinate the safest plan. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Timing of procedures

Very VERY good question.  To be honest Megan, ideally both at the same time.  That way you do not have to deal with anesthesia and recovery from surgery twice.  That being said, if you had to do one vs the other, do the jaw surgery first.  Mind you, this comes with a caveat which I will get to.  The reason you do the jaw first is that if your oral surgeon and orthodontist believe that they have to displace the upper jaw in any way in order to get your dental occlusion perfect, then that will affect the position of your nose.  It will affect it such that if you did the nose first, it would change the result of your surgery, leading you to possibly need a follow up tip plasty or minor revision to get it just right.  The caveat, as I mentioned, is if your docs feel as though they will need to adjust your upper jaw as well.  In essence, discuss this with them as any experienced ortho-oral surgery team will be able to tell you what the plan is.  Best of luck! The combination of jaw surgery/rhinoplasty is one of my favorites in terms of dramatic, natural looking results.  I hope some of this helps!

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.