What is jaw surgery?
Jaw surgery — known medically as orthognathic surgery — is a surgical procedure that repositions one or both jaws to correct their relationship to each other and to the rest of the face. It is performed by an oral and maxillofacial surgeon in close collaboration with your dentist — the two work as a team throughout your entire treatment journey.
Jaw surgery can:
Move the upper jaw forward, backward, upward, or downward
Move the lower jaw forward or backward
Correct asymmetries of the face and jaws
Reposition the chin
Improve bite function — including chewing, biting, and speaking
Improve breathing and airway function in some patients
Improve facial balance and profile
Jaw surgery is not only a cosmetic surgery — it is a functional procedure that corrects a structural problem. The improvement in facial aesthetics is a welcome outcome, but the primary goal is always to achieve a correct and functional bite.
Who needs jaw surgery?
Jaw surgery is recommended when:
The jaw discrepancy is too significant to be fully corrected with orthodontics alone
The patient has finished growing — jaw surgery is not performed until growth is complete, typically in the late teens for girls and early twenties for boys
The patient has realistic expectations and is prepared for the surgical process and recovery
Common conditions treated with jaw surgery include:
Severe underbite — lower jaw significantly protrudes beyond the upper
Severe overbite — upper jaw or teeth significantly protrude beyond the lower
Open bite — upper and lower front teeth do not meet when biting
Severe crossbite — upper and lower jaws are significantly misaligned from side to side
Significant facial asymmetry — one side of the face is noticeably different from the other
Severe breathing difficulties related to jaw position
What to expect — the jaw surgery journey
Jaw surgery is not a standalone procedure — it is part of a carefully coordinated treatment plan that involves orthodontics before and after surgery. Here is an overview of the full journey:
Phase 1 — Pre-surgical orthodontics
Before surgery, you will undergo a period of orthodontic treatment — typically 12–18 months — to align and level the teeth within each jaw in preparation for surgery
Paradoxically, your bite may actually look and feel worse during this phase before it gets better — this is completely normal and expected. The teeth are being deliberately positioned to fit together correctly after the jaws are moved
Do not be alarmed if your bite feels more uncomfortable during this phase — trust the process and communicate with your dentist
Phase 2 — The surgery
Jaw surgery is performed under general anaesthesia in a hospital operating theatre — you will be completely asleep throughout the procedure
The surgery is performed entirely inside the mouth — there are no external cuts or visible scars on the face in the vast majority of cases
The surgeon makes precise cuts in the jawbone, repositions the jaw to the planned position, and secures it in place with small titanium plates and screws — these remain permanently in place and do not need to be removed in most cases
Common surgical procedures include the Le Fort I osteotomy (upper jaw), bilateral sagittal split osteotomy or BSSO (lower jaw), genioplasty (chin), or a combination of these for bimaxillary surgery
Surgery typically takes 2–5 hours depending on the complexity and number of jaw movements involved
Phase 3 — Hospital stay and immediate recovery
Jaw surgery requires a hospital stay — you will be monitored closely by the surgical team before being discharged
You will wake up from surgery with significant facial swelling, numbness, and discomfort — this is completely expected
Pain relief and anti-inflammatory medications will be prescribed and administered by the hospital team
A liquid diet begins immediately after surgery — your surgical team will advise on appropriate foods and drinks
Phase 4 — Recovery at home
Facial swelling is one of the most significant aspects of recovery — it peaks at approximately 48–72 hours after surgery before gradually improving
Most patients experience significant swelling for approximately 4–6 weeks after surgery — residual swelling can persist for several months and the final result is not fully visible for up to 12 months
In the first few weeks after surgery, your teeth may be held together with elastics or wires — this restricts mouth opening and means you will need to follow a strict liquid diet during this period. A blender becomes essential!
The liquid diet phase typically lasts for a few weeks before gradually progressing to soft foods as healing progresses and the jaw fixation is released
Most patients are able to return to work or school within 2–4 weeks depending on the nature of their work and their individual recovery
Numbness of the lips, cheeks, and chin is common and sensation returns gradually over weeks to months — in some cases up to 12–18 months
Phase 5 — Post-surgical orthodontics
Once initial healing is confirmed — usually 4–8 weeks after surgery — your dentist will resume active orthodontic treatment to fine-tune the bite and finalise tooth positions
This post-surgical orthodontic phase typically takes 6–12 months
Retention with retainers follows the completion of treatment
Surgical risks — what you need to know
Jaw surgery is a major surgical procedure and like all surgeries it carries risks. Your surgeon will discuss these with you in detail before obtaining your consent — but here is an overview of the most commonly discussed risks:
Swelling and bruising — significant and expected, resolves over weeks to months
Altered or reduced sensation — numbness of the lips, cheeks, chin, and gums due to nerve involvement during surgery. Usually temporary but can take up to 12–18 months to fully resolve. In rare cases some altered sensation may be permanent
Infection — risk is minimised with antibiotics and meticulous oral hygiene
Bleeding — managed during surgery and monitored during hospital stay
Relapse — some degree of jaw movement back towards the original position can occur — which is why the post-surgical orthodontic phase and long-term retention are so important
Airway concerns — particularly in the immediate post-operative period. You will be closely monitored by the surgical team
Anaesthetic risks — as with any procedure under general anaesthesia
Unsatisfactory aesthetic outcome — thorough pre-surgical planning including digital imaging and model surgery minimises this risk
Need for further surgery — in rare cases a revision procedure may be needed
It is important to have an open and thorough conversation with your surgeon about all risks before proceeding with surgery. Do not hesitate to ask questions — an informed patient is always a better-prepared patient.
The journey is long — typically 2–3 years in total from the start of pre-surgical orthodontics to the end of post-surgical treatment. The recovery requires patience and resilience. But for the right patient, the results are transformative and lasting.
