Jaw surgery (orthognathic surgery) is a specialized procedure designed to correct significant irregularities of the jaw bones. It is necessary when the upper jaw, lower jaw, or both are misaligned, creating a skeletal discrepancy that orthodontics alone cannot correct. The primary goal is to improve function by properly aligning the bite for better chewing and speech, and to achieve greater balance in the facial features. By repositioning the jaw structure, the procedure addresses issues like severe overbites, underbites, and open bites rooted in the bone structure. This correction provides a stable foundation for the teeth and contributes to overall facial harmony.
The Pre-Surgical Preparation Phase
The initial stage of treatment involves pre-surgical orthodontics, typically utilizing braces or aligners, to move the teeth into specific positions. This preparation ensures that when the jaw bones are surgically repositioned, the teeth will fit together precisely. Aligning the teeth relative to their jaw arches can take anywhere from six to eighteen months.
During this period, patients often observe that their bite seems to worsen temporarily. The orthodontic adjustments are designed to fully expose the underlying skeletal problem, making the misalignment more pronounced before the surgical correction. Visually, the patient has orthodontic appliances, and the temporary exaggeration of the jaw discrepancy is noticeable.
Near the end of this phase, final records, including computed tomography (CT) scans and dental models, are taken. This allows the surgeon and orthodontist to virtually plan the exact movements of the jaw bones, which is fundamental to achieving the intended functional and aesthetic results.
Immediately After the Operation
The immediate appearance following jaw surgery is defined by significant facial swelling, the body’s natural response to the manipulation of bone and soft tissues. Swelling is most pronounced around the cheeks, lips, and lower face, making the face look noticeably puffy. Peak swelling typically occurs between 48 and 72 hours post-operation. Patients are instructed to use cold therapy, such as ice packs, continuously for the first two to three days to minimize this initial edema.
Bruising is also common, presenting as discoloration along the jawline that can travel down the neck. The bruising resolves over one to two weeks, changing color from purple/blue to green/yellow. The jaw is stabilized using tiny elastic bands or wires attached to the orthodontic hardware. These bands guide the jaws into their new position and severely restrict movement, causing immediate difficulty with speaking and swallowing. In some cases, small drainage tubes may be visible for the first 24 hours to remove excess fluid and blood.
The Recovery and Healing Timeline
Following the initial peak, the most noticeable facial swelling begins to subside rapidly during the second and third weeks of recovery. Major swelling reduction usually occurs within the first four weeks, though a subtle puffiness often persists for several weeks to months. Final soft tissue contours and definition may not be fully apparent until six to twelve months after the procedure. Managing this gradual and protracted swelling is an aspect of the intermediate recovery phase.
Dietary restrictions significantly influence the patient’s lifestyle during the initial healing period, which is necessary to protect the repositioned bone segments. Patients adhere to a full liquid diet immediately after surgery, gradually transitioning to soft, non-chew foods over the following six to eight weeks. This progression is carefully managed by the surgical team to ensure adequate nutrition while preventing stress on the healing jaw bones. Most normal activities, including returning to work or school, can resume after one to three weeks, though strenuous activities are restricted for several months.
Another common experience is an altered sensation, or paresthesia, in the lower lip, chin, and sometimes the upper lip and nose, resulting from nerve manipulation during the operation. While this numbness often begins to resolve within the first few weeks, it can take four to six months for significant improvement. Although the majority of patients recover most sensation over time, a small area of altered sensation may persist indefinitely in some instances. The recovery timeline is a dynamic process marked by functional milestones, such as regaining jaw mobility and transitioning to a normal diet.
Long-Term Functional and Aesthetic Outcomes
The final appearance of the patient is revealed only after the complete resolution of swelling, which typically occurs between six and twelve months post-surgery. At this point, the permanent alteration to the facial profile becomes stable, reflecting the surgically achieved skeletal alignment. The newly repositioned jaw structures create a more balanced facial appearance, correcting issues like a recessed chin or a prominent underbite. The aesthetic outcome includes improved chin projection, a more defined jawline, and enhanced facial symmetry.
Functionally, success is measured by the stability of the corrected bite, known as occlusion. The repositioned jaws allow the teeth to meet correctly, which improves chewing efficiency and reduces abnormal wear on the teeth. Many patients also experience improvements in speech clarity and breathing, particularly those who had a compromised airway due to their original jaw position. Metal plates and screws used to fix the bones in place are generally permanent and rarely require removal unless a problem arises. The long-term stability of the skeletal changes is high, and the functional and aesthetic results are designed to last for decades.