Double jaw surgery, formally known as bimaxillary orthognathic surgery, is a complex procedure designed to correct significant misalignments between the upper jaw (maxilla) and the lower jaw (mandible). This surgery involves carefully separating, repositioning, and securing the bones of both jaws to achieve a balanced and functional skeletal structure. The decision to undergo such an extensive medical process requires an objective evaluation of the potential benefits against the substantial commitment, cost, and inherent medical risks. Determining if this intensive treatment is “worth it” depends on an individual’s specific needs, tolerance for a prolonged timeline, and their ability to navigate the financial and physical demands of the process.
The Core Motivation: Correcting Functional and Aesthetic Issues
The primary reason individuals seek double jaw surgery is to resolve severe functional impairments that cannot be treated effectively by orthodontics alone. This procedure is necessary for correcting skeletal malocclusion, where the upper and lower teeth do not meet correctly. Correcting this misalignment directly improves mastication, making it easier to bite and chew food efficiently.
A significant functional motivation is the treatment of obstructive sleep apnea (OSA) caused by a deficient jaw structure. Maxillomandibular advancement, a specialized version of the surgery, repositions both jaws forward, increasing the volume of the posterior airway space. This advancement is an effective treatment for patients who have failed or cannot tolerate continuous positive airway pressure (CPAP) therapy.
While functional improvements are the medical drivers, enhanced facial harmony and aesthetics are a major secondary benefit. Repositioning the jaws can correct facial asymmetries, balance a receding or overly prominent chin, and harmonize the facial profile. These aesthetic changes often contribute to a significant improvement in self-confidence and overall quality of life.
Understanding the Commitment: The Full Treatment Timeline
The total time commitment for double jaw surgery often spans two to three years. This prolonged process demands patience and significant lifestyle alteration.
Pre-Surgical Orthodontics
The process begins with the pre-surgical orthodontic phase, which uses braces or aligners to move the teeth into positions that align with the planned surgical jaw movements. This preparatory phase typically lasts between 12 and 18 months. During this time, the patient’s bite may temporarily appear worse as the teeth are positioned for the future surgical fit.
The Surgical Procedure and Initial Recovery
The surgery itself is a hospital-based procedure performed under general anesthesia, usually requiring four to seven hours. Patients typically spend one to two nights in the hospital for monitoring and pain management. The initial recovery period at home is intensive, requiring four to eight weeks off from work or school to manage swelling, bruising, and fatigue. Dietary restrictions are substantial during this post-operative phase, limiting patients to a liquid or pureed diet for several weeks to allow the jawbones to heal.
Post-Surgical Orthodontics
After the initial recovery, the post-surgical orthodontic phase begins, lasting an additional six to twelve months. This phase refines the bite and ensures the teeth are fully settled in the new jaw position. Patients must be prepared for the psychological strain of this prolonged treatment, including the temporary worsening of bite alignment and the significant lifestyle adjustments required.
Navigating Potential Post-Operative Complications
As a major surgical intervention, orthognathic surgery carries specific risks that must be weighed carefully.
Neurosensory Disturbance
One of the most common complications is neurosensory disturbance, or paresthesia, which is numbness or altered sensation in the lower lip and chin following the lower jaw procedure. The vast majority of patients experience initial numbness, with some studies reporting rates as high as 68 percent immediately after surgery. This numbness is usually temporary, gradually resolving over six months as the nerve heals. However, a small percentage of patients experience permanent altered sensation, with long-term numbness persisting for 9 to 30 percent of patients one year after the procedure.
Infection and Relapse
Other risks include surgical site infection, which occurs in a low rate, generally ranging from 1.4 to 8 percent of cases. Infections are more common in bimaxillary procedures compared to single-jaw surgery. Another complication is skeletal relapse, where the repositioned jawbones shift slightly back toward their original position over time. Relapse, defined as a change greater than two millimeters, occurs in approximately 24 percent of bimaxillary surgery cases. Maxillary advancement procedures are relatively stable, but mandibular setback and inferior repositioning of the maxilla carry a higher tendency for relapse.
The Financial Investment and Insurance Coverage
The monetary cost of double jaw surgery is substantial, often totaling tens of thousands of dollars without insurance coverage. The surgical phase alone, including the surgeon’s fee, hospital facility fees, and anesthesia, typically ranges from $30,000 to over $50,000 in the United States. This figure excludes the mandatory pre- and post-surgical orthodontic treatment, which adds several thousand dollars to the total expense.
Insurance coverage is a crucial factor, as most health plans only cover the procedure if it is deemed medically necessary. This necessity must be clearly documented by the surgical team, usually requiring evidence of a functional impairment, such as severe malocclusion or structural issues causing obstructive sleep apnea. Documentation often requires specific skeletal discrepancy measurements or results from a sleep study.
Purely aesthetic adjustments are excluded from insurance coverage. Patients must obtain pre-authorization before treatment begins, demonstrating that the surgery addresses a physical health problem, not just an appearance concern. Even with coverage, patients should anticipate substantial out-of-pocket expenses, as deductibles, copayments, and the orthodontic phase often fall to the patient.
Deciding if the Investment is Right for You
The question of whether double jaw surgery is a worthwhile investment requires an honest assessment of functional need versus personal capacity. The procedure offers profound improvements in quality of life for those suffering from severe malocclusion, chronic pain, or breathing difficulties related to jaw structure. These benefits must be measured against the two to three-year commitment, which demands patience, resilience, and significant lifestyle alteration.
Potential patients must realistically weigh the possibility of complications, particularly the risk of long-term altered sensation in the lower face. The financial impact is also a decisive factor, necessitating a thorough understanding of insurance coverage and a readiness to cover substantial out-of-pocket costs. Consultation with a multidisciplinary team, including an oral and maxillofacial surgeon and an orthodontist, is an important first step to establish clear, realistic expectations for the entire process and the final outcome.