Orthognathic surgery, commonly known as corrective jaw surgery, is a procedure designed to fix misaligned jaws, improve the bite, and address functional issues like chewing difficulties or sleep apnea. The process is a comprehensive journey with multiple phases that span a considerable length of time. Understanding this timeline is important, as the surgery is only the middle step of a much longer treatment plan involving extensive preparation and structured recovery.
The Pre-Surgical Orthodontic Phase
The actual jaw surgery is preceded by a significant period of preparation involving orthodontic treatment. This initial phase is often the longest commitment in the entire process, typically lasting between 12 and 24 months. The purpose of this pre-surgical orthodontics is to align the teeth into their correct positions within each jawbone individually. This movement ensures that when the jaws are surgically repositioned, the upper and lower teeth will interlock perfectly to create a stable bite.
Moving the teeth into this preliminary alignment often makes the patient’s bite appear worse temporarily, a necessary step known as “decompensation.” The exact length of this phase is influenced by the complexity of the original malocclusion and whether tooth extractions are required. Cases involving the removal of teeth (excluding wisdom teeth) can extend the pre-surgical phase by an average of eight to ten months. Patient cooperation, such as maintaining appliance hygiene and attending appointments, also plays a direct role in keeping the timeline on track.
Operating Room Duration
The time spent in the operating room (OR) is highly dependent on the type and extent of the jaw movement required, covering the period from the start of general anesthesia until the patient moves to recovery. A procedure involving only the lower jaw, such as a bilateral sagittal split osteotomy (BSSO), generally takes about 1.5 to 3 hours. Maxillary (upper jaw) surgery, often a Le Fort I osteotomy, typically lasts 2 to 4 hours, reflecting the careful repositioning of the upper jawbone.
The most extensive procedure, known as bimaxillary or double jaw surgery, involves both the upper and lower jaws and consequently requires the longest time. This combined operation typically ranges from 4 to 6 hours in the operating room. The complexity of the specific movements and the amount of bone reshaping needed are the main factors determining the duration. This time includes securing the repositioned bone segments with small titanium plates and screws before the patient is awakened.
Immediate Post-Operative Recovery
Following surgery, the immediate recovery phase begins, focusing on initial healing and managing swelling and discomfort. Most patients spend one to three nights in the hospital for monitoring, pain management, and steroid administration to control swelling. The most pronounced swelling and bruising usually peak around the third or fourth day after the operation. While pain is managed with medication, intense swelling is the primary discomfort during this phase.
A strict diet progression is necessary in the first weeks following surgery and is paramount for proper bone healing. Patients must adhere to a liquid-only or pureed diet for the first four to six weeks to prevent force on the healing bone segments. Advancing too quickly to solid foods risks disrupting the fixation plates and screws, which could compromise the surgical results. The diet gradually progresses to soft, non-chew foods before a slow return to a normal diet begins around weeks seven to eight.
Temporary numbness is a common side effect, particularly in the lower lip, chin, and sometimes the upper cheek area, due to nerve manipulation during the procedure. While some sensation may return within hours or days, the full recovery of feeling is a much slower process, often taking several weeks to months. A return to school or a desk-based job is possible within two to four weeks. However, strenuous activity and contact sports must be avoided for at least six to eight weeks to protect the healing jaw.
Total Treatment Length and Timeline Variables
The entire orthognathic treatment is a multi-year commitment. The total process, from the start of pre-surgical orthodontics to the completion of post-surgical finishing, usually spans between two and three years. The surgery and immediate recovery represent a small, intense window within this much longer duration.
After the initial post-operative healing, a final phase of orthodontics is necessary to fine-tune the bite and achieve the final alignment of the teeth. This post-surgical phase typically lasts an additional six to twelve months. The overall length of treatment is subject to several variables, including the patient’s biological healing rate and adherence to post-operative instructions, such as wearing prescribed rubber bands.
The initial severity of the skeletal and dental malocclusion is the most significant determinant of the total treatment length. Cases requiring extensive jaw movement or complex tooth extractions often require longer preparation and finishing phases. Patient age can also play a role, as the healing and bone remodeling process tends to be more predictable in younger adults.