Orthognathic surgery, also known as corrective jaw surgery, repositions the jaw bones to address structural and dental irregularities. Performed by an oral and maxillofacial surgeon, often with an orthodontist, the primary goals are to create a proper bite and enhance facial harmony. The procedure can involve the upper jaw, lower jaw, or both to achieve a balanced result.
Functional Improvements After Surgery
A primary functional benefit of orthognathic surgery is improved chewing and biting. When the jaws are correctly aligned, the teeth meet properly, allowing for more efficient processing of food and reducing strain on the jaw muscles. Correcting this malocclusion, or bad bite, makes eating more comfortable and helps prevent uneven wear on the teeth.
The repositioning of the jaws can also lead to improvements in breathing, particularly for individuals with obstructive sleep apnea. By moving the jaw bones, the surgery can enlarge the airway, making it easier to breathe during sleep. This can reduce or eliminate snoring and the pauses in breathing associated with sleep apnea.
Improvements in speech clarity are another functional outcome. The precise positioning of the teeth and jaws is important for articulating sounds correctly. Correcting a jaw misalignment that interferes with speech patterns can lead to clearer, more natural-sounding speech.
Many patients experience a reduction in chronic jaw pain. Misalignment can cause persistent discomfort in the temporomandibular joint (TMJ). By correcting the structural issues that lead to TMJ disorders, the surgery can alleviate symptoms like jaw tension, clicking, and associated headaches.
Aesthetic Transformations
Orthognathic surgery improves the facial profile and overall balance. Moving the maxilla (upper jaw) or mandible (lower jaw) alters the relationship between the chin, lips, nose, and forehead. For instance, correcting a recessed lower jaw or a protruding upper jaw establishes a more harmonious facial structure.
The surgery is also effective at correcting facial asymmetry, with studies showing an average 21% improvement. Discrepancies in the size or position of the jawbones on either side of the face can create an unbalanced appearance. By precisely repositioning these bones, surgeons can achieve a more symmetric look.
The procedure can also improve the smile’s aesthetics. Issues such as a “gummy” smile, where excessive gum tissue is visible, or a smile that shows too few teeth can be corrected. By repositioning the upper jaw, the surgeon can control the amount of tooth and gum exposure.
Corrective jaw surgery provides better support for the soft tissues of the lower face. The new bone position affects the overlying muscles and skin, which can improve lip posture and the definition of the chin. This structural support helps create a more balanced facial appearance.
Timeline for Seeing Final Results
The initial recovery phase, spanning the first few weeks, is characterized by swelling and bruising that will mask the surgical outcome. Discomfort is most pronounced during this period, and patients are typically on a liquid or soft food diet. The final appearance is not yet evident at this stage.
Between one and three months post-procedure, most of the swelling subsides, revealing the improvements in facial structure. Around 80-90% of the swelling typically resolves during this time. While some residual puffiness may remain, the new jaw alignment is clearly apparent, and most patients can return to work or school.
The final results are visible from six months to one year post-operatively. During this period, the last traces of swelling disappear as the soft tissues adapt to the new skeletal foundation. Complete bone healing takes time, with the outcome considered stable and final around the one-year mark.
Ensuring Long-Term Stability
To ensure the results last, a phase of post-surgical orthodontics is often necessary. After the jaw has been repositioned, braces or clear aligners are used to fine-tune the bite. This guides the teeth into their optimal final positions, creating a stable occlusion that supports the new jaw alignment.
Lifelong retainer wear is a common requirement to maintain stability. As with standard orthodontic treatment, teeth have a natural tendency to shift over time. Consistent use of retainers, as prescribed by the orthodontist, prevents this movement and protects the new alignment.
While orthognathic surgery has high success rates, the potential for minor changes over many years, known as relapse, exists. This is typically minimal and can be influenced by factors like growth, muscle adaptation, and bone remodeling. Following the instructions provided by the surgical and orthodontic team is the most effective way to minimize this risk.