Jaw (orthognathic) surgery
Jaw surgery is for people who are unhappy with the balance of their face, or how their teeth and jaws meet (their bite). It is used to reposition the jaws and correct any imbalance between the upper and lower jaws. This allows the teeth to bite together correctly.
The surgery also affects the way that the face looks, especially from the side. Many people who decide to have the surgery want to achieve this.
There are sometimes other treatment options that do not involve surgery. We explain if any of the options are suitable for you and how the results would look different. These options might be a compromise. It is important to understand what each option would achieve.
Deciding to have jaw surgery
We only do jaw surgery if this is something that you want.
In total, the treatment takes about 3 years. This is because you need to have braces fitted before surgery. Braces are usually fitted 18 to 24 months (2 years) before jaw surgery.
Speaking to a clinical psychologist
Some people find it difficult to decide whether to have jaw surgery. It can help to talk about your decision with someone who is not involved in your treatment.
A clinical psychologist can help you decide what to do and talk through your hopes and expectations for the surgery. You can also speak to them about practical issues, such as when to have the surgery and how to fit the appointments around your work.
Cleft palate and speech
If you were born with a cleft palate (a gap or split in the roof of your mouth), you will have a speech assessment before deciding whether to have jaw surgery.
Sometimes, if the top jaw is moved forwards, the soft part of the palate might no longer reach the back of the throat. This can change the sound of your voice because air can get into the nose as you talk. If this problem does happen, you might need more surgery.
The speech assessment helps to show whether we can treat this problem if it happens.
Changes to your face
Jaw surgery balances the bones of the face so that the facial features are in proportion with each other, and the teeth can bite together correctly. You still look like yourself and are recognisable to family and friends after jaw surgery. However, some features of your face change.
It takes months after surgery for you to see your final appearance. This is because any swelling needs to reduce, and the shape of your face will change.
Most people are happy with the changes to their face. You are welcome to see photographs of other people before and after their jaw surgery when you come to your appointments.
Usually, the surgeon makes all of the cuts needed for surgery from inside the mouth. This is so there are no visible scars. Sometimes, the surgeon needs to make a small (2mm) cut on the jaw line. This is almost invisible a few weeks after surgery.
Read more information on recovering from jaw surgery.
Braces before jaw surgery
To prepare your teeth for surgery, you need braces. It is important to move the teeth with braces to make sure that they meet together correctly after jaw surgery.
Braces are usually fitted 18 to 24 months (2 years) before jaw surgery. If your teeth are healthy, they can be fitted as soon as you decide to have surgery.
Braces stay on during surgery, and you usually wear them for 6 months to 1 year after surgery.
- While you wear the braces, you need appointments every 6 to 8 weeks for an orthodontist to check them.
- You also need to see your dentist for regular dental check-ups every 6 months.
When the braces are removed, we recommend that you wear a removable brace (retainer) at night. This keeps the teeth in their new position.
Braces instead of surgery
It is not always possible to correct the teeth and the bite with braces. This is because the bones of the face and jaws might be out of balance with one another. For example, you might have a small upper jaw and a larger lower jaw. Braces can move the teeth, but cannot move the jaws in the same way as jaw surgery.
Risks of jaw surgery
In our hospital, this is routine surgery. Our surgeons, anaesthetists and nurses are all specialised and experienced in looking after people before and after jaw surgery.
Any type of surgery has some risk. Your medical team talks to you about any risks at your clinic appointments. Risks for this type of surgery are rare and might not apply to everyone.
Your lips are numb for a short time after surgery. The top lip usually returns to normal quickly. The bottom lip can take 6 to 9 months to feel normal.
For some people, the feeling in the lip never completely returns but this is very rare. As the lips still look and move as before, this rarely causes any problems.
We usually leave the tiny fixing plates used during surgery in place permanently. Sometimes (less than 1 in 10 cases), we have to remove the plates due to an infection. As the bones have usually healed in full, taking out the plates out does not make the jaw weaker.
Movement of the jaw position
For most people, the risk of the jaws moving back to the position that they started in is not a problem. However, for more complicated jaw movements (such as people who had previous operations on their palate or jaws), the risk can be higher.
If you are more at risk of the jaws moving position after surgery, your surgeon and orthodontist might review you more often. You might need extra elastic bands or even a slightly different appliance (device). Very rarely, you might be offered more surgery. You can choose whether to have more surgery.
There is a risk that there might be an increase in the nasal tone of your speech, or air coming down the nose when you speak, after surgery. A nasal tone is when it sounds like there is too much or too little air in your nose when you speak.
You have a speech assessment before jaw surgery to see if you are at risk of speech changes.
Any changes might be temporary and you might recover slowly. However, they can also be permanent unless you have more speech surgery. We explain this to you in more detail at the planning clinics.
Giving your permission (consent)
We ask you to sign a consent form that says you agree to the treatment and understand what it involves. If there is anything that you do not understand or if you need more time to think, please tell the staff caring for you.
Remember, it is your decision whether to have jaw surgery. You can change your mind at any time, even if you have signed the consent form. We respect your wishes at all times.
There is a lot of online information about jaw surgery, but some is more helpful than others. We recommend the information from the British Orthodontic Society.