Orthognathic surgery, commonly known as corrective jaw surgery, is a specialized procedure used to correct significant problems with the position and alignment of the upper jaw, lower jaw, or both. When the jaws do not develop in proper alignment, it can affect more than appearance—it may make chewing, speaking, breathing, and maintaining good oral health more difficult.
For people with certain jaw abnormalities that cannot be fully corrected with orthodontic treatment alone, orthognathic surgery can help create better jaw function, improve facial balance, and support long-term oral health.
What Is Orthognathic Surgery?
The word “orthognathic” refers to properly aligned jaws. Orthognathic surgery involves repositioning the jawbones to improve their relationship with each other and with the rest of the face.
The procedure is generally performed by an oral and maxillofacial surgeon, often working closely with an orthodontist. Orthodontic treatment is commonly needed before and after surgery to align the teeth and achieve a stable bite.
Orthognathic surgery may involve the:
- Upper jaw (maxilla)
- Lower jaw (mandible)
- Chin
- Both upper and lower jaws
The exact surgical approach depends on the individual’s jaw structure, bite, facial proportions, and treatment goals.
Who May Need Orthognathic Surgery?
Orthognathic surgery may be recommended when a jaw or bite problem is significant and cannot be adequately corrected with braces or clear aligners alone.
Some common conditions that may lead to corrective jaw surgery include:
Underbite
An underbite occurs when the lower teeth extend beyond the upper teeth. Significant underbites may be associated with an underdeveloped upper jaw, an overdeveloped lower jaw, or a combination of both.
Overbite
A deep or excessive overbite occurs when the upper front teeth significantly overlap the lower front teeth. Severe cases may affect chewing and cause excessive wear on the teeth.
Open Bite
With an open bite, some upper and lower teeth do not meet when the mouth is closed. This can make biting and chewing certain foods difficult.
Facial Asymmetry
Differences in the size or position of the jaws can cause noticeable facial asymmetry. Corrective surgery may help improve the balance between the two sides of the face.
Jaw Growth Problems
Some people develop significant differences between the upper and lower jaws as they grow. These differences can affect facial appearance as well as dental function.
Functional Problems
Severe jaw discrepancies may contribute to difficulty chewing, speaking, swallowing, or maintaining proper oral hygiene.
In some patients, jaw structure may also contribute to certain breathing-related problems. A specialist evaluation is necessary to determine whether orthognathic surgery is appropriate.
What Are the Benefits of Orthognathic Surgery?
The benefits of orthognathic surgery vary from person to person and depend on the underlying condition. Potential benefits include:
1. Improved Bite and Chewing
Correcting jaw alignment can improve the way the upper and lower teeth come together. This may make biting and chewing more comfortable and efficient.
2. Better Facial Balance
Moving the jaws into a more appropriate position can improve facial proportions and symmetry. Many patients experience a more balanced facial appearance following treatment.
3. Improved Speech
Certain jaw and bite abnormalities can affect speech. Correcting the underlying structural problem may improve speech function in some patients.
4. Easier Oral Hygiene
When teeth and jaws are properly aligned, maintaining oral hygiene may become easier. Better access to the teeth can support long-term dental health.
5. Reduced Jaw Strain
Correcting an abnormal bite may help reduce excessive stress on certain teeth and jaw structures. However, surgery is not a guaranteed treatment for every type of jaw-joint or facial pain.
6. Improved Quality of Life
For people whose jaw condition significantly affects daily activities, correcting the underlying problem may improve comfort, confidence, and overall quality of life.
What Happens Before Orthognathic Surgery?
Orthognathic surgery requires careful planning. Your treatment team will first perform a comprehensive evaluation of your teeth, jaws, facial structure, and bite.
Planning may include:
- Dental and facial examinations
- X-rays
- 3D imaging such as CBCT scans when appropriate
- Dental impressions or digital scans
- Facial photographs
- Orthodontic assessment
- Computer-assisted surgical planning
In many cases, orthodontic treatment begins before surgery. Braces or aligners may be used to position the teeth so that the jaws can be surgically aligned correctly.
Your surgeon and orthodontist will develop an individualized treatment plan based on your specific anatomy and goals.
What Happens During Orthognathic Surgery?
Orthognathic surgery is performed under general anesthesia. Most incisions are made inside the mouth, which means visible external scars are generally minimized.
Depending on the treatment plan, the surgeon may reposition the upper jaw, lower jaw, or both.
The jawbones are carefully divided and moved into the planned position. Small plates and screws are typically used to stabilize the bones while they heal.
The exact duration of surgery varies depending on the complexity of the procedure and the number of jaw segments being treated.
After surgery, you will be monitored in a recovery area and may remain in the hospital for observation depending on the procedure and your individual circumstances.
What Is Recovery Like?
Recovery is an important part of orthognathic treatment. Swelling and bruising are common during the first several days and gradually improve.
Your surgeon will provide specific instructions regarding:
- Diet
- Oral hygiene
- Medications
- Physical activity
- Follow-up appointments
- Orthodontic treatment
A soft or liquid diet is commonly required during the early healing period. As healing progresses, your surgeon will advise you when you can gradually return to more normal foods.
Most people can resume many normal daily activities within several weeks, but complete bone healing takes longer. The overall recovery timeline varies according to the procedure, individual healing, and treatment complexity.
Numbness or altered sensation, particularly around the lips or chin after lower-jaw surgery, can occur. It often improves with time, although recovery of sensation varies between individuals and some changes can persist.
What Results Can You Expect?
Orthognathic surgery is designed to produce both functional and structural improvements.
Once healing and orthodontic treatment are complete, patients may notice:
- A more balanced bite
- Improved chewing function
- Better alignment of the jaws
- Improved facial proportions
- Greater ease with certain daily activities
- Improved confidence in their appearance
Results are highly individual. The final appearance may continue to change subtly as swelling decreases and tissues settle during the healing process.
It is also important to understand that orthognathic surgery is not simply a cosmetic procedure. Its primary purpose is to correct significant skeletal and dental discrepancies and improve function, although facial appearance often improves as a result.
Are There Risks?
Like any major surgical procedure, orthognathic surgery has potential risks. These may include infection, bleeding, swelling, nerve-related sensory changes, changes in bite, problems with bone healing, relapse of jaw position, and the need for additional treatment.
Your surgeon will discuss the potential risks and expected benefits with you before treatment. Individual risks depend on factors such as the type of surgery, general health, anatomy, and treatment complexity.
How Long Does Orthognathic Treatment Take?
Orthognathic treatment is usually a process rather than a single appointment. Orthodontic preparation may take several months, followed by surgery and a period of healing and post-surgical orthodontic treatment.
The total treatment time varies significantly from patient to patient. Your orthodontist and oral and maxillofacial surgeon can provide a more accurate estimate after completing your evaluation.
Is Orthognathic Surgery Right for You?
If you have a significant bite problem, jaw discrepancy, facial asymmetry, or difficulty with chewing or other oral functions, you may benefit from an evaluation by an orthodontist and oral and maxillofacial surgeon.
Not everyone with a misaligned bite needs surgery. Mild and moderate dental alignment problems can often be treated with orthodontics alone. Orthognathic surgery is generally considered when the underlying skeletal problem is significant enough that orthodontic treatment alone cannot provide the desired correction.
Final Thoughts
Orthognathic surgery can provide an effective solution for people with significant jaw and bite abnormalities. By repositioning the jaws into a more functional relationship, treatment can improve chewing, bite alignment, facial balance, and in appropriate cases, other aspects of oral function.
Successful treatment depends on careful diagnosis, detailed surgical planning, coordinated orthodontic care, and proper recovery.
If you are experiencing a severe bite problem, jaw imbalance, facial asymmetry, or difficulty with chewing, speak with a qualified orthodontist or oral and maxillofacial surgeon. A thorough evaluation can determine the cause of the problem and whether orthognathic surgery is an appropriate treatment option for you.