What Is orthognathic surgery?
Orthognathic surgery — commonly referred to as jaw surgery — is a procedure that corrects skeletal discrepancies of the upper and/or lower jaw.
It is performed to improve:
- Bite alignment
- Jaw function
- Facial balance
- Breathing in select cases
Unlike routine dental treatment, jaw surgery addresses the underlying bone position, not just the teeth.
Common procedures include:
- LeFort I Osteotomy – repositioning of the upper jaw
- Bilateral Sagittal Split Osteotomy (BSSO) – repositioning of the lower jaw
- Genioplasty – repositioning of the chin for functional or aesthetic balance
These procedures allow us to correct jaw misalignment in ways braces alone cannot.
Why would someone need jaw surgery?
Orthognathic surgery is considered when there is a skeletal discrepancy that cannot be corrected with orthodontics alone.
Common indications include:
- Severe overbite or underbite
- Open bite
- Facial asymmetry
- Difficulty chewing
- Speech concerns
- Jaw pain related to malalignment
- Obstructive sleep apnea (in selected cases)
- Relapse after previous orthodontic treatment
In many patients, surgery improves not only function but also facial harmony and long-term dental stability.
The timeline: what to expect
It is a carefully coordinated, multi-stage treatment that typically takes 12–18 months from start to finish.
Phase 1: Orthodontic preparation
You will typically wear braces for about 6-24 months before surgery.
During this time, your orthodontist aligns the teeth into their correct positions over their respective jaws. Sometimes this temporarily makes the bite look “worse,” but it prepares the jaws for proper surgical correction.
Phase 2: Surgical planning
We use:
- Clinical exams
- Photographs
- Digital models
- 3D imaging
- Virtual surgical planning
Precise measurements are made to determine ideal jaw positioning.
Phase 3: Surgery
Surgery is performed at Community Hospital of the Monterey Peninsula under general anesthesia.
Most patients stay in the hospital for 1–2 nights for monitoring and comfort.
Phase 4: Postoperative orthodontics
After surgery, braces remain in place for several months to fine-tune the bite.
What happens after surgery?
Immediately after surgery:
- You will have elastic rubber bands between your teeth to guide your bite
- Your jaws are not wired shut
- Swelling is expected and peaks around days 2–3
- Bruising is common
Diet
You will be on a no-chew diet for several weeks. This includes:
- Smoothies
- Soups
- Protein shakes
- Soft, blenderized foods
Nutrition is very important during healing.
What is recovery like?
Swelling is normal and can take several weeks to improve significantly. Final swelling resolution may take several months.
Numbness — especially of the lower lip and chin after a BSSO — is not uncommon. In most cases, sensation gradually improves over months. In rare cases, some numbness may persist.
To support healing, we recommend:
- Frequent icing during the first several days
- Head elevation while sleeping
- Rest
- Gentle oral hygiene with a pediatric toothbrush
- Chlorhexidine mouth rinse to keep the mouth clean
Most patients return to school or light activity within 2–3 weeks.
Full bone healing occurs over several months.
Risks of orthognathic surgery
Orthognathic surgery is a major surgical procedure.
While it is performed safely and predictably, risks do exist.
Possible risks include:
- Swelling and bruising
- Bleeding
- Infection
- Numbness (temporary or, rarely, permanent)
- Relapse or bite shifting
- Need for additional orthodontic adjustment
- Hardware irritation requiring removal
- Very rarely, serious medical complications
We review all risks in detail during your consultation so you can make an informed decision.
Frequently asked questions
Answers to the questions we hear most from patients.
Will my jaws be wired shut?
How long will I be swollen?
Will I have numbness?
Is jaw surgery worth it?
For properly selected patients, jaw surgery can be life-changing.
It can:
- Dramatically improve bite function
- Improve breathing in certain cases
- Improve facial balance
- Reduce long-term wear on teeth
- Increase confidence
However, it is a serious commitment — involving braces, surgery, healing, and follow-up care.
It is not cosmetic surgery alone. It is a functional reconstruction of the bite and jaws.
How do I know if I’m a candidate?
We evaluate:
- Your bite relationship
- Skeletal discrepancy
- Facial balance
- Symptoms
- Orthodontic status
- Overall health
Then we collaborate closely with your orthodontist to determine the best course of action.
