Orthognathic Surgery refers to a surgical procedure to move one or both of the jaws in order to achieve ideal teeth and airway function and facial balance.
The most common reason a person would consider corrective jaw surgery is due to a congenital misalignment of the jaws, typically a size discrepancy between the upper and lower jaw. Other reasons include obstructive sleep apnea as an alternative to continuous positive airway pressure (CPAP) or prior traumatic injury.
Unfortunately, this typically does not lead to optimal results. When an orthodontist attempts to tip the teeth to mask a skeletal discrepancy with orthodontics alone the teeth are often stretched to the edge of their bony housing to overcome the foundational jaw problem. This is the opposite direction the teeth would be moved for the surgical option, which aims to settle the teeth in a healthy position and angulation in the bone prior to correcting the underlying foundational problem. While it is always possible to use corrective jaw surgery to improve the alignment and balance of the jaws. The end result is more optimal when a combined surgical orthodontic treatment plan is established from the start.
If you are having jaw surgery, by definition, at least one jaw will be moved. In almost every case, the jaw that is relatively small will be advanced, if your upper teeth are behind your lower teeth, the upper jaw moves forward, if your lower teeth are further behind your lower teeth than they should be, your lower jaw moves forward. Moving the jaw forward has a much better esthetic result and improves your airway. However, sometimes both jaws need to move to obtain an ideal result. Often this is not known until your pre-surgical orthodontic phase is complete. It is important to note, that moving both jaws does not mean twice the investment from a patient perspective. The pre and post orthodontic phase is the same and the recovery is very similar regardless of moving one or both jaws. This decision is a joint decision with your surgeon and unique to each patient. We are happy to review the details of this on a case-by-case basis in your consultation so you can choose the best path for you.
Your teeth are not wired together after surgery. You can open your mouth, speak, and drink immediately after surgery. While this used to be common with jaw surgery, improved fixation techniques and plating technology has made this obsolete.
The vast majority of our patients stay only one night in the hospital. We will never kick you out of the hospital after surgery if you still need the support, but our patients are almost always feeling ready to leave the hospital the morning after their surgery. In fact, not all patients even stay one night in the hospital. For certain patients jaw surgery can be performed in our surgery center using the same anesthesiologist and equipment as the hospital. The only difference is that these patients spend their first night after surgery at home.
Yes, you can eat, you just cannot chew for 6 weeks. However, there are many things you can eat without chewing including soft scrambled eggs, refried beans, yogurt, whipped mashed potatoes, creamy soups, protein shakes, milkshakes and anything you want to put in a blender. Believe it or not people get quite creative and blenderized pizza or pasta tastes much better than it sounds.
This is decided through a collaborative evaluation of your specific case by your orthodontist and surgeon during your consultation. Sometimes it is possible to predict at the initial consultation, but often we need to wait until after the pre-surgical orthodontic movement is complete to finalize this recommendation for you.
In many cases you can have jaw surgery with Invisalign. However, your orthodontist will need to evaluate your specific case to know if this is possible for you.
As with any surgery, post operative pain, swelling, and some bleeding is expected. All of these side effects will improve with time as your body heals. Infection is possible after any surgery, but fortunately, it is rare in jaw surgery. When infection does occur it is typically minor and can be treated with antibiotics or a minor procedure to wash the area and encourage natural healing. Numbness or decreased sensation is possible after surgery. During the surgery the nerves that provide sensation, not motor movement, of the face are commonly stretched. For the upper lip and face it is extremely rare for there to be any lasting change. However, with lower jaw surgery there is a risk of some permanent change in sensation to the lower lip. This is more common with larger movements of the jaw which result in more stretching and in older patients, over 25 years of age.