Orthognathic surgery involves repositioning the upper jaw (maxilla) and/or lower jaw (mandible) by moving them into desired positions to correct jaw deformities.

This treatment is reserved for patients with severe jaw deformities who have completed their growth and development. Most candidates have limited social interactions due to their appearance, have difficulty chewing and speaking properly, experience joint pain, and in very advanced cases, suffer from apnea attacks affecting their breathing. In milder cases, the problem may not be as severe, but the patient may have serious aesthetic concerns. The decision for treatment should be made collaboratively by the orthodontist and the patient.

Like all medical treatments, patients should be fully informed about their options. For example, in a patient with a jaw problem, the severity of the issue, which jaw is affected, whether the teeth can be properly aligned with orthodontics alone (non-surgical), the pros and cons of non-surgical versus surgical treatments, and all outcomes after treatment should be explained in detail. Photographs of patients who have undergone surgery are usually shown, allowing the patient time to decide.

Orthognathic surgery requires a team approach. Essential members include an orthodontist and a surgeon who performs the operation. The surgery is typically done by an experienced plastic surgeon or maxillofacial surgeon.

Orthognathic surgeries are complex and must be performed by skilled specialists. Successful treatment — especially in severe cases — can transform the patient’s psychosocial well-being and quality of life. After treatment, patients often gain confidence, feel comfortable in social settings, smile freely, enjoy eating normally (like biting an apple or eating sunflower seeds), speak clearly (pronouncing letters such as f, t, s, z properly), experience reduced snoring, and can comfortably close their mouth and lips during sleep.

Orthodontic Preparation Before Jaw Surgery

Before surgery, the patient undergoes orthodontic treatment to prepare the jaws and teeth so they will fit together properly during the operation. This preparation phase usually lasts about one year. The orthodontist aligns the front and back teeth to ensure the face achieves an ideal profile balance once the jaws are repositioned. Detailed examination and planning are critical at the start of treatment.

Additionally, any impacted wisdom teeth should be removed at least 10 weeks prior to surgery.

Once the patient is ready for surgery, an experienced orthodontist prepares the case and plans the precise jaw movements. The orthodontist also fabricates a surgical guide (“splint”) that assists the surgeon during the procedure.

How Long Does Jaw Surgery Take?

Jaw surgeries may involve one or both jaws and are performed under general anesthesia. Depending on the surgery, the procedure lasts between 2 and 6 hours. After repositioning the upper jaw, lower jaw, and possibly the chin (genioplasty), titanium plates and screws are used to stabilize the bones.

Post-Surgery Process

• Hospital stay: Usually 1-3 days

• Medications: Antibiotics and pain relievers are continued for about one week at home

• Oral hygiene: Antiseptic mouthwashes are recommended to maintain cleanliness

Pain and Swelling After Surgery

Like all surgeries, jaw surgery causes swelling and pain. The extent depends on the procedure’s scope, location, and duration. To minimize swelling, applying ice packs during the first 24 hours is important. Regular use of prescribed medications helps reduce pain and swelling. Most swelling subsides within the first month, but complete resolution can take up to a year. Limited mouth opening due to swelling may occur during the first week but typically normalizes within a month. Pain usually decreases significantly after 3 days, though it can last up to a week.

Use of Elastics After Surgery

Patients usually wear elastics for 3-4 weeks postoperatively. The type and intensity of elastic use vary depending on the surgery performed. Some cases require light elastics, while others may require strong elastics that limit jaw movement.

Diet After Jaw Surgery

For the first month, patients should consume liquid or very soft foods that require minimal chewing, such as high-vitamin nutritional drinks, soups, yogurt, and bone broth. Some patients may experience dizziness or low blood pressure during the first week. Good nutrition supports quick recovery and blood restoration. After the first month, semi-solid foods can be introduced gradually to begin exercising the chewing muscles. The initial liquid diet period is often the most challenging for patients, but after about 3 weeks, they can consume more satisfying foods.

Orthodontic Treatment After Surgery

Post-surgical orthodontic treatment typically lasts 3 to 6 months, depending on the dental condition.

Numbness After Jaw Surgery

In lower jaw surgeries using the common “sagittal split osteotomy” technique, the inferior alveolar nerve is located close to the surgical site. While care is taken not to damage this nerve, temporary numbness in the lower lip is expected and considered normal, lasting from 2 months up to 1 year. Your doctor may recommend vitamin supplements to support nerve healing.

Removal of Plates and Screws

Titanium plates and screws used during surgery are similar to those used in orthopedic bone surgeries and are biologically safe. They generally do not need to be removed. However, if desired by the patient, they can be removed by the surgeon at least one year after surgery.

If you need more information or personalized consultation, feel free to ask!