Bimaxillary Surgery: What It Is and What to Expect

Bimaxillary surgery, or bimaxillary osteotomy, is a corrective procedure on both the upper (maxilla) and lower (mandible) jaws. This surgery is performed to correct misalignments when orthodontic treatments alone are insufficient. The procedure addresses functional problems and aesthetic concerns by repositioning the jawbones to create a more balanced and functional bite in a single operation.

Reasons for Bimaxillary Surgery

This surgery is recommended for individuals with moderate to severe jaw problems that cannot be resolved with braces. A primary reason is to correct malocclusion (the misalignment of teeth and jaws), which includes conditions like a significant overbite, underbite, crossbite, or an open bite. These issues can cause difficulty with chewing, swallowing, and speaking.

Beyond bite correction, bimaxillary surgery addresses other functional issues. Obstructive sleep apnea, a condition where breathing repeatedly stops and starts during sleep, can be resolved by moving the jaws forward to open the airway. The procedure is also used to correct congenital conditions or facial asymmetry, where one side of the face is noticeably different from the other.

When a bite discrepancy is large, operating on both jaws allows for greater flexibility and a more stable outcome. This approach can also prevent unfavorable changes to the soft tissues of the face that might occur if a large corrective movement was confined to a single jaw.

The Surgical Process

Bimaxillary surgery is a collaboration between an oral and maxillofacial surgeon and an orthodontist. Pre-surgical planning involves 3D imaging and CT scans to create a precise surgical plan. Patients wear braces for several months before the operation to align the teeth for their new, corrected position.

The surgery is performed under general anesthesia. To avoid visible scarring, the surgeon typically makes incisions inside the mouth. Through these incisions, the surgeon cuts the upper and lower jawbones and moves them into their predetermined positions.

Once aligned, the jaws are secured with small, biocompatible titanium plates and screws. These fixtures are generally left in place permanently unless a complication, such as an infection, arises.

The Recovery Journey

The recovery period requires patience and adherence to post-operative instructions. An initial hospital stay of one to three days is typical, during which pain and swelling are managed with medication. Swelling peaks within the first few days, gradually subsiding over several weeks, and it is common to experience a blocked nose and discomfort with swallowing.

A strict diet is a key part of the initial recovery. For the first several weeks, patients are limited to a liquid or pureed diet to avoid putting strain on the healing jaws. Most patients can return to school or work within two to four weeks, depending on the physical demands of their activities.

Over the next few months, the diet progresses from pureed to soft foods, and a normal diet can be resumed once healing is complete. Regular follow-up appointments with the surgeon and orthodontist are necessary to monitor healing and make any adjustments. Complete healing of the jawbones can take several months.

Expected Outcomes and Changes

After fully healing, patients experience improvements in both function and aesthetics. The procedure corrects foundational issues that braces alone could not, leading to a properly aligned bite. This correction makes chewing food easier and can lead to clearer speech. For those who underwent surgery to address sleep apnea, the repositioning of the jaws can improve breathing.

The surgery also produces noticeable aesthetic enhancements by creating a more balanced facial profile. Correcting issues like a severe underbite or a recessed chin results in improved facial symmetry and proportion. These changes can have a positive impact on a person’s self-esteem and overall quality of life.