Orthognathic Surgery: A Complete Guide to Corrective Jaw Surgery
Orthognathic surgery (corrective jaw surgery) is no small matter. It is the last resort for the 5 percent of the adult population for whom braces and other orthodontic treatments are not adequate. For these individuals, corrective jaw surgery can be a life-changing procedure.
Corrective jaw surgery can include structural and cosmetic reconstruction. It is often performed to correct skeletal malformations or anatomical anomalies associated with the lower jaw (mandible) or the upper jaw (maxilla). Orthognathic surgery is also carried out to reposition misaligned jaws and correct other skeletal deformities that are not fixed with braces. It can also uplift, restore, and renew a person's jaw and facial features.
Orthognathic jaw surgery is a major medical procedure, and with the right guidance, advice, and experienced medical professionals on your side, it can be something well worth the investment.
"At Facial & Oral Surgery Institute, elite medical professionals are the experts that general and family dentists refer their patients to for particularly complex or challenging procedures that require surgical knowledge, experience, and skill."
--- NAVID SENEHI, DDS. MD.
What is Orthognathic Surgery?
Orthognathic surgery, more commonly referred to as corrective jaw surgery, is a surgical procedure designed to repair and improve conditions of the face and jaw.
Jaw surgery is generally not recommended except in cases where orthodontic and prosthodontic solutions, such as braces and implants, have failed in adequately solving a problem of the face and jaw.
An orthognathic surgical procedure is typically performed by a highly skilled oral and maxillofacial surgeon like Dr. Navid Senehi, DDS. MD. of Facial & Oral Surgery Institute. As an oral and maxillofacial surgeon, Dr. Senehi has invested extensive training beyond dental school. Upon completion of dental school, Dr. Senehi pursued his medical degree. He was selected for 1 of only 5 residency positions available at the world-renowned UT Southwestern Medical Center in Dallas, Texas. It was there that Dr. Senehi learned, practiced, and honed his skills and training in a highly demanding setting.
Following Dr. Senehi's residency at UT Southwestern Medical Center and becoming board certified as an oral and maxillofacial surgeon, Dr. Senehi founded Facial & Oral Surgery Institute.
At Facial & Oral Surgery Institute, elite medical professionals are the experts that general and family dentists refer their patients to for particularly complex or challenging procedures that require surgical knowledge, experience, and skill. In this instance, orthognathic procedures would fall under the purview of an oral and maxillofacial surgeon.
In most cases, the oral surgeon is a part of a larger team of doctors and specialists. Typically, a general dentist makes the initial referral while working with an orthodontist to create, monitor, and manage braces and retainers for use prior and after an orthognathic procedure. Prosthodontists may also be involved when the use of prosthetic devices, such as dental implants, are necessary.
There are many reasons that a doctor or dentist may recommend a patient to an orthognathic surgeon such as Dr. Senehi. Typically, these have to do with conditions of the face and jaw, especially dental deformities that involve underlying bone and tissue structures.
Conditions and Situations That May Require An Orthognathic Procedure
- Dentoalveolar surgery
- Complex dental implant procedures
- Bone grafting procedures
- Sleep apnea
- Temporomandibular Jaw (TMJ) disorders
- Arthritis in the face and jaw
- Malocclusion as a result of skeletal disharmonies
- Gross jaw discrepancies
- Severe underbite (mandibular prognathism)
- Severe overbite (maxillary prognathism)
- Cleft lip and palate
- Tumors affecting the jaws
- Pathology affecting the jaws
Treating severe dental and jaw deformities is vital for a person’s overall health. Skeletal deformities that make chewing, biting, swallowing, or breathing difficult pose a challenge to normal day to day life. Aesthetic deformity or disharmony can also impose a hefty psychological burden on some patients. Ultimately, treating severe jaw conditions aggressively with orthognathic surgery may be the best and only option for many individuals who have exhausted other options.
Step By Step Overview of the Corrective Jaw Surgery Process
Corrective jaw surgery is a multi-step process that may involve physicians, dentists, and specialists with a variety of roles and different backgrounds. While the actual orthognathic procedure can be completed in a single operation, there may be weeks or even months of preparation necessary before the surgery, followed by weeks or even months of a recovery period. This guide is intended to help our patients understand each step of the orthognathic procedure from beginning to end on their way to a better self.
How to Prepare for an Orthognathic Procedure
Before an orthognathic procedure, the necessary preparatory groundwork must first be completed. This will include initial consultations and a dental exam to determine if orthognathic surgery is the best course of action or if another dental path, such as orthodontics, would be a better course of action to achieve the goal. Together with the dentist and the orthodontist, Dr. Navid Senehi, DDS. MD. of Facial & Oral Surgery Institute will create a treatment plan best suited to the individual needs of the patient.
If orthognathic surgery is determined to be the best course of action, specific procedures must be performed first. Relationship of upper teeth and jaw to cranium will be recorded. Anatomic landmarks will be reviewed based on the documented relationship as well as analysis of multiple types of images of the face and jaws. An impression of the teeth will be taken to help fabricate custom splints and molds to guide the surgical process and subsequent recovery.
Preliminary orthodontic treatment most likely will be recommended to help move teeth into the correct position to make surgery and recovery less complicated and the results more stable. If orthodontic treatment is required, the orthognathic procedure will have to be delayed until the teeth have moved into an ideal position.
Remember, orthodontics and orthognathic surgery are two separate dental procedures that work together to solve malocclusion or misalignment of teeth. Orthodontics is primarily concerned with how a patient’s teeth fit together, while orthognathic treatments are concerned with how a patient’s jaws fit together or in other words skeletal correction of misaligned teeth. Other preparatory dental work may include extracting broken or damaged teeth.
What To Expect During Surgery
Once a patient’s teeth are adequately prepared, the actual orthognathic procedure can be done. Depending on the patient and the surgical scope, those receiving a corrective jaw surgery generally can expect a one to two-day hospital stay.
First, the patient will be undergoing general anesthesia for the duration of the procedure. During the operation, the jaws and teeth are aligned. This may entail adding, removing, reshaping, or relocating the position of various segments of the facial skeleton and may require the use of surgical plates, screws, wires and rubber bands. Necessary incisions are made in the inner mouth where they won’t be seen and sutured once the operation is complete.
In most instances, both jaws are wired together for a short period of time, often by utilizing previously placed orthodontic braces, in a process known as maxillomandibular fixation (MMF) to allow the jaws heal with minimal movement. During the surgery, a breathing tube, as well as an intravenous catheter, will also be put in place to deliver and monitor adequate ventilation, even provide sufficient nutrients, fluids, and different types of medications.
Dr. Senehi, the anesthesiologist, and the clinical staff will help ensure a seamless surgical experience that is as comfortable as possible. Patients will not feel any pain during the procedure.
What to Expect After Surgery and During Recovery
Patients can expect their jaws to be held in place by heavy elastic bands or wires immediately following the surgery.
Two to three weeks after the orthognathic operation, wires are removed and replaced by elastic bands or the heavy elastic bands are replaced with lighter ones. These should be worn for at least the first two weeks of the recovery period. Patients who underwent significant jaw movement or repositioning may be required to wear their elastic bands for 4 to 6 weeks or longer to prevent misalignment or relapse.
Initial diet during the first two months should consist of soft food only to reduce stress on the jaws and make eating easier. Some patients may find blended food and beverages to be the easiest and most comfortable way to get the nutrients they need. The lighter secondary elastic bands can be removed during meal times to aid in routine dental hygiene.
After about 4 to 5 weeks, most patients will be able to open their mouth and flex their jaws again fully. It should be noted that some patients may require additional time or physiotherapy to help them regain a full range of motion of their jaws.
Regular follow-up appointments will be required the first six weeks following an orthognathic procedure to monitor the healing and recovery process and to make sure that everything is progressing as planned. Complete healing of the jaw bones should take between 4 to 6 months or more depending on the scope of the surgical intervention.
Side Effects and Complications After Surgery
Corrective jaw surgery is a major medical procedure with a correspondingly lengthy recovery period of a few months to half a year or longer. During the recovery period, patients may experience some inconvenience and discomfort. This can usually be attributed to the natural healing process. Patients can experience lip numbness, swelling, weight loss, pain, restricted jaw movements, difficulty speaking, and scarring. Most or all of these initial challenges can be overcome with time or with additional treatments aimed at mitigating discomfort and problems.
How To Choose an Oral and Maxillofacial Surgeon
A successful, aesthetic, and stable orthognathic procedure requires deft and experienced hands as well as well-trained eyes for dentofacial proportions and placement. The best doctors produce the best results. Choosing the right professionals to execute your orthognathic procedure is critical. This is true for corrective jaw surgeries which often require careful coordination between an orthodontist and an oral and maxillofacial surgeon like Dr. Navid Senehi. For patients, corrective jaw surgery represents a new hope for correcting severe jaw or facial deformities.
How Much Does Orthognathic Surgery Cost?
Due to the highly coordinated, multidisciplinary, and complex nature of an orthognathic procedure, corrective jaw surgery can be expensive without insurance. The average cost for orthognathic surgery is in the range of $15,000 to $40,000. This price should include initial consultations, doctor and surgeon’s fees, and any follow-up care.
Prices often do not include any orthodontic or prosthodontic work necessary either before or after the primary orthognathic operation. If additional orthodontic work is not included, expect to pay an extra $2,000 to $10,000 for the necessary braces.
Some patients may be covered under their dental insurance plans depending on the conditions that prompted the necessity for surgery. Many insurance plans will cover patients who receive orthognathic surgery to treat sleep apnea, breathing problems, or speech impediments caused by skeletal deformities.
To get a more accurate idea about the potential financial impacts of corrective jaw surgery, it is helpful to schedule an initial consultation with Dr. Senehi who can assist you with strategy, financial options, and a treatment plan.
You can reach us at 818-805-0557 during normal business hours. You can also click the Chat button located in the bottom right-hand corner of this page and chat with a person from our team who is eager to help you. If you prefer, just click the Schedule An Appointment button below and we will help you get started with an initial consultation.