Orthognathic Surgery (Jaw Surgery)

Procedure overview

Orthognathic surgery, commonly known as jaw surgery, is a corrective maxillofacial procedure aimed at repositioning the jaws to restore occlusal balance, facial symmetry, and functional efficiency. It is often indicated for patients with skeletal malocclusion, facial asymmetry, or airway obstruction, offering both aesthetic and functional enhancement through precise surgical correction.

Ideal candidates

Inclusion Criteria:

• Patients with skeletal malocclusion (Class II or Class III).

• Facial asymmetry, chin deviation, or vertical maxillary excess.

• Airway-related issues like obstructive sleep apnea (OSA).

• Individuals with stable periodontal and dental health.

Exclusion Criteria:

• Uncontrolled systemic conditions.

• Active oral infections or poor dental hygiene.

• Unrealistic aesthetic expectations.
  
  

Procedure details

The procedure involves precise osteotomies—controlled surgical cuts in the jawbones—to reposition them into anatomically correct alignments. Depending on the deformity, either or both jaws may be repositioned in three dimensions (anterior-posterior, vertical, or transverse).
Once realigned, titanium plates and screws are used to secure the bones in their new position, providing rigid fixation and stability. Over time, natural bone healing (osteogenesis) occurs around the fixation points, ensuring a permanent correction of the skeletal discrepancy. This surgical correction harmonizes the relationship between the upper and lower jaws, resulting in improved bite mechanics, facial balance, and airway function.

1. Pre-Surgical Phase

• Orthodontic Preparation (6–18 months): Braces are used to align and level the teeth in each jaw, preparing them for ideal occlusion post-surgery.

• Imaging and Planning: 3D cephalometric analysis, CT scans, and digital models are used to simulate jaw movement and plan the osteotomy sites precisely.

• Patient Counseling: The patient is informed about the expected outcomes, recovery timeline, and potential risks.

2. Surgical Phase

• Anesthesia: The surgery is performed under general anesthesia in a hospital or surgical center.

• Osteotomies: Depending on the deformity, procedures such as Le Fort I osteotomy (maxillary) or bilateral sagittal split osteotomy (BSSO) (mandibular) are performed.

• Repositioning and Fixation: The jaws are repositioned based on preoperative planning and secured with titanium miniplates and screws.

• Duration: The surgery typically lasts 3–6 hours, depending on complexity.

3. Post-Surgical Phase

• Immediate Recovery: The patient may stay in the hospital for 1–3 days. Swelling, discomfort, and temporary numbness are expected.

• Bone Healing: Rigid fixation allows early jaw mobility, reducing the need for maxillomandibular fixation (jaw wiring).

• Diet & Rehabilitation: A soft or liquid diet is maintained for several weeks, followed by gradual reintroduction of solid foods.

• Physiotherapy: Exercises to restore jaw movement, speech, and muscle function are initiated gradually.

• Follow-Up: Regular dental and surgical reviews ensure stable occlusion and functional recovery.
  
  

Costs and insurance

Cost Factors: 
In India, orthognathic surgery cost ranges between ₹2,00,000–₹8,00,000 per jaw, depending on complexity, hospital setup, and surgeon specialization. Bimaxillary orthognathic surgery costs may exceed ₹8,00,000 due to dual-jaw correction, extended operative time, and complexity of the surgery.

Insurance Coverage: 
Orthognathic surgery is often partially covered when performed for functional reasons (e.g., malocclusion correction, airway obstruction), but cosmetic cases may not qualify for coverage.

Benefits

• Functional Improvement: Corrects bite alignment, mastication, and speech.

• Aesthetic Enhancement: Improves jawline, facial balance, and symmetry.

• Health Benefits: Relieves temporomandibular joint (TMJ) strain and sleep apnea.

• Long-Term Stability: Permanent correction with durable skeletal outcomes.
  
  

Risks and complications

Orthognathic surgery is generally safe, but complications may occur.

Common Side Effects

• Facial swelling, bruising, and mild postoperative pain.

• Temporary numbness due to inferior alveolar or infraorbital nerve traction.

Rare Complications

• Infection, malunion, or relapse of bone segments.

• TMJ discomfort or occlusal instability.

• Airway obstruction in the immediate postoperative period.
  
  

Patient experiences

Immediate Post-Surgery (1–2 Days):

Patients remain hospitalized for monitoring of airway, bleeding, and occlusion. IV fluids, analgesics, and antibiotics are administered. Soft liquid intake and antiseptic mouth rinses begin once stable.

Initial Healing (2–3 Weeks):

Soft tissue healing and edema reduction occur. A soft or liquid diet is maintained to prevent strain on fixation. Mild nerve paresthesia may persist. Oral hygiene and limited jaw movement are essential for recovery.

Complete Recovery (8–12 Weeks):

Bone consolidation and functional normalization take place. Gradual reintroduction of solid foods is permitted. Residual swelling subsides, and facial symmetry becomes apparent. Patients can resume routine activity after surgeon clearance.

Rehabilitation Phase:

Physiotherapy restores jaw mobility and muscle coordination. Follow-up orthodontic refinement ensures optimal occlusion. Periodic reviews and imaging confirm bone healing and fixation stability.

Expert opinions

Experts highlight its combined benefits in enhancing facial harmony and restoring optimal jaw function.

Efficacy Data
Clinical studies demonstrate marked improvement in occlusal alignment, facial balance, and aesthetic outcomes, with high patient satisfaction observed in jawline contouring and post-orthognathic results.

Safety Profile
Conducted under sterile, monitored hospital conditions, orthognathic surgery shows low complication and low relapse rates when performed by experienced surgeons.

Regulatory and ethical considerations

Professional Requirements
Only certified oral and maxillofacial surgeons should perform orthognathic procedures in accredited medical facilities.

Informed Consent
Patients must receive detailed information about risks, realistic results, and the orthognathic surgery recovery time before undergoing treatment.

Technological advancements

The latest advancements in digital technology, has transformed orthognathic surgery, enabling surgeons to achieve greater precision, predictability, and personalized results for enhanced functional and aesthetic outcomes.

3D Virtual Surgical Planning (VSP):

Enables preoperative simulation of orthognathic surgery before and after results with precision-guided osteotomies.

Plates and Cutting Guides: 

3D printed custom guides and implants provide accurate repositioning and faster healing.

AI and augmented reality: 

Promotes planning and intraoperative guidance, 

Alternative treatment

While orthognathic surgery provides definitive correction for skeletal discrepancies, several less invasive alternatives may help improve mild to moderate jaw misalignments or aesthetic concerns:

1. Orthodontic Treatment Alone:
   Braces or clear aligners can correct dental malocclusion and improve bite alignment when skeletal discrepancy is minimal.

2. Dental Restorations:
   Crowns or veneers can modify tooth shape or height to improve occlusion and facial balance without surgery.

3. Dermal Fillers and Botox:
   Injectables help enhance jawline definition, correct minor asymmetries, or relax overactive muscles for a more balanced facial appearance.

4. Chin Augmentation (Genioplasty):
   A surgical or implant-based procedure to improve lower facial proportions without altering the jawbones.
   
   

Disclaimer

This content is intended for educational and informational purposes only. Always consult a board-certified oral and maxillofacial surgeon for an individualized assessment before undergoing orthognathic surgery.

Conclusion

Orthognathic surgery represents the intersection of aesthetic enhancement and functional rehabilitation in maxillofacial medicine. By realigning the skeletal framework, it improves facial harmony, occlusion, and airway function with long-term stability. Modern 3D-guided techniques have made orthognathic surgery before and after transformations safer, more predictable, and highly satisfying for patients.

At Cosma Beauty, our board-certified maxillofacial surgeons integrate advanced virtual planning, precision osteotomies, and patient-specific implants to deliver optimal surgical outcomes—balancing medical excellence with facial artistry.

FAQs

1.How long does orthognathic surgery take?

Depending on complexity, surgery lasts 3–6 hours under general anesthesia.

2. What is the average orthognathic surgery recovery time?

Most patients return to normal activity in 4–6 weeks, with full bone healing by 12 weeks.

3. What is the difference between maxillary and bimaxillary orthognathic surgery?

Maxillary orthognathic surgery corrects upper jaw deformities, while bimaxillary surgery involves both upper and lower jaws for complete facial correction.

4. Are results permanent?

Yes. Once bone fusion occurs, results are permanent, barring trauma or severe relapse.