What is Orthognathic Surgery?
Orthognathic surgery is a term used to refer to a variety of surgical procedures of the jaw and correct jaw alignment problems. It can be done for purely cosmetic reasons or to treat functional problems caused by abnormal jaw alignment. Abnormal or miss-match jaw alignment are medically called “Malocclusion”.
The upper (maxillary) and lower (mandibular) jaw are usually aligned with the upper and lower teeth fitting perfectly together. However, in some people, this might not be the case. Genetics are usually the cause, however, sometimes, facial trauma can cause jaw and mouth deformity requiring orthognathic surgery.
Upper and lower jaw malalignment and other concerns might be caused by:
- Maxillary (upper) jaw over or under-protrusion
- Mandibular (lower) jaw over or under-protrusion
- Teeth misalignment
- All of the above
This is why surgery to correct the jaw is sometimes complicated and requires a multidisciplinary team approach. This can include an orthognathic surgeon, plastic surgeon, orthodontist, periodontists, endodontists, and general dentist. The treatment plan may involve months or years of orthodontic treatment (e.g. braces) and requires extensive coordination between your surgeon and dentist.
Classification of Jaw Abnormalities
The jaw consists of an upper and lower part. The upper part, or maxilla, holds the upper set of teeth. The lower part, called the mandible holds the lower set of teeth.
The alignment of the upper and lower parts together determines how your jaw looks.
For example, if your lower teeth are in front of your upper teeth when you close the jaw, then it might be caused by an over-protruding lower jaw (prognathism) or under protruding upper jaw.
Moreover, the alignment and protrusion of the teeth also play an important role.
As such, jaw shape abnormalities treated by orthognathic surgery can be classified into:
- Class I: when the upper and lower jaw are in a harmonious relationship and the lower fist molar is just in front of the upper 1st molar
- Class II when the lower jaw appears retracted and your upper teeth are in front. This can be caused by an over-protruding upper jaw, or under-protruding lower jaw – also called “Retrognathism”
- Class III: This is when your lower jaw and teeth are protruding in front of the upper teeth – the lower teeth are too forward. This can be caused by under-protruding upper teeth or an over-protruding lower jaw – also called “Prognathism”
“Prognathism” and “retrognathism” are used when the problem is exclusively in the lower jaw.
Other concerns with the jaw bones’ width, size, and shape also play an important role in determining your facial aesthetics. This is why orthognathic surgery is planned on a case-by-case basis.
When is Jaw Surgery or Orthognathic Surgery Required?
Jaw shape and alignment abnormalities may cause both cosmetic and functional problems. As such, you are considered a good candidate for corrective jaw surgery if you have:
- Small chin
- Broad or wide face
- Disproportionate smile
- Unsatisfactory facial profile (chin protruding or receding)
- Overprotruding teeth
- Underprotruding teeth
- Anaesthetic smile
- Temporomandibular joint (TMJ) pain
- Sleep apnoea
- Problems with chewing
- Problems with speech and pronunciation
- Problems with biting food
- Teeth degeneration
- Lips don’t fully close
Corrective jaw orthognathic surgery is planned according to your specific anatomy and specific concerns. In addition to functionally improving your bite and mouth function, it is designed to alter the appearance of the jaw. By addressing the alignment of the teeth, chin, and other facial features, your face will look more proportional – front and profile.
Why Patients Might Consider Orthognathic Surgery
Corrective surgery of the jaw addresses both the shape of your jaw and face, as well as several oral functions that might be concerning you. As such, patients might seek out orthognathic surgery for many reasons, including:
- Helping to fix overbite, underbite, crossbite, and small chin
- Improving speech and pronunciation
- Improving biting, chewing, and swallowing functions
- Improving sleep apnoea and snoring symptoms
- Protecting the teeth from further damage
- Improving the smile
- Improving front and profile appearance of the face
- Improving the chin shape and jaw/neck lines
The specific procedure you get will be planned according to your own cosmetic goals and complaints.
Preparing for Orthognathic Surgery
Jaw misalignment, or Orthodontic Malocclusion, requires a comprehensive treatment plan that might extend for months or years. It requires coordination between Dr Maryam, a general dentist, orthodontist, and/or endodontist.
X-rays and sometimes a CT scan of the jaw are ordered to further visualise the anatomy of the jaw and put a treatment plan. You might need to wear orthodontic appliances (e.g. braces) for months or years before your surgery.
Orthognathic surgery is customised according to your individual anatomy. Dr Maryam uses virtual surgical planning (VPS) software to virtually reconstruct your face and jaw and find the optimal surgical approach. VPS allows Dr Maryam to visualise how the surgical outcomes would be before orthognathic surgery is done.
How is Orthognathic Surgery Performed ?
Corrective jaw surgery is usually done under general anaesthesia. You will be fully asleep during the procedure. You should expect to spend a night or two at the hospital for monitoring after your surgery.
Based on your individual anatomy, VPS outcomes, and cosmetic desires, Dr Maryam will perform one or more of the following surgical procedures to correct your jaw shape and alignment:
- Maxillary Osteotomy (upper jaw surgery): if the upper jaw is retracted Dr Maryam will first cut the Maxillary bone above your upper teeth. She will then move the upper jaw (and teeth) forward to make it align with the lower teeth and jaw. If the upper jaw is over-protruding, the maxillary bone will be shaved to become less protruding
- Mandibular Osteotomy (lower jaw surgery): this surgery is usually done to fix either prognathism or retrognathism due to lower jaw problems. If the lower jaw is protruding forward Dr Maryam will cut a piece of the Mandibular bone and move the whole lower jaw backward to reduce its protrusion. If the lower jaw is receding, the mandible will be cut and the whole jaw is moved forward
- Teeth removal: teeth might be removed if the jaw needs to be pushed backward. This might be necessary for Class II and Class III jaw misalignment
- Bone grafting: if the upper or lower jaw is not protruding enough, Dr Maryam will extend the jaw’s forward protrusion. To do this, she might take a piece of bone from your hip bone and implant it in the maxilla or mandible. This surgery can correct retrognathism due to an under-protruding mandible
- Genioplasty (chin reshaping surgery): if the chin is prominent, then Dr Maryam might cut above it, remove a small piece of bone, and move the whole chin inward. Genioplasty can also aim to make the chin appear pointier. The chin can also be brought forward to become more protruding if you have a receding chin.
In addition, Dr Maryam might reshape the jaw bones in a way to fix other asymmetries, such as problems with width, alignment, and shape. When osteotomy and bone repositioning are done, titanium plates/screws are used to fix the bone in its new position.
In most cases, jaw correction orthognathic surgery is done from inside the mouth – no external skin incisions. However, sometimes, a small incision at the angle of the mandible might be needed.
Recovery after Orthognathic Surgery
Recovery after jaw orthognathic surgery requires some planning ahead. You’ll need to take time off work for at least 2-3 weeks to rest at home. Full recovery after orthognathic surgery needs 4-6 weeks on average.
During the first 2 weeks, you might experience some expected side effects. These include bleeding, facial bruising, swelling, and jaw pain. Fully opening the mouth, eating, and drinking might be a little challenging at first and require some getting used to.
In the early recovery period, you might need to commit to a fluid diet – juice, yogurt, soup. You can gradually start eating more solid foods as the weeks pass. It is not uncommon for patients to lose weight after corrective surgery of the jaw.
You should brush your teeth consistently after orthognathic surgery to keep the mouth clean, however, make sure you use a soft toothbrush and brush gently.
The swelling will significantly subside after 6 weeks of your jaw surgery, and you will start noticing the dramatic change in your facial appearance. Some swelling might persist for a few months and will eventually go away, allowing you to enjoy the full results of your surgery.
Real Patient Results for Corrective Jaw Surgery
The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Jaw Correction Orthognathic Surgery Sydney Costs - How much does jaw correction orthognathic surgery cost in Australia NSW?
The cost of jaw correction orthognathic surgery differs on a case-by-case basis. Orthognathic surgery varies depenning on your needs. The surgical technique and procedure are different based on each patient’s individual anatomy, cosmetic desires, and needs.
For example, underbite correction might require bone grafting in one patient, but only osteotomy in another. The costs are understandably different for each case. Some patients might need both upper and lower jaw surgery to correct the deformity, which can also affect the costs.
Is Jaw Correction surgery covered by Medicare or private health insurance?
Medicare and insurance might cover orthognathic surgery in Australia. If you are getting jaw correction surgery to treat a functional disorder (e.g. sleep apnoea, chewing difficulty, speech problems, etc.) then it may be considered as a medical necessity. Such cases might be eligible for a rebate from Medicare or insurance. Please call the clinic team to find out more.
Find out more about a Jaw Correction Orthognathic Surgery Payment Plan, or the costs for other face surgery on our Surgical Costs page.
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Considering Corrective Jaw Orthognathic Surgery?
Is orthognathic surgery necessary?
Jaw correction surgery is not only done for cosmetic purposes, it can fix functional problems related to chewing, biting, eating, and speaking. It can also be an essential part of sleep apnoea treatment – a chronic breathing condition that might affect your whole body.
How can you fix a receding chin?
If you have retrognathism, then genioplasty (chin surgery) or orthognathic lower jaw surgery might be required to fix it. Genioplasty might be enough if the problem is localised only in the chin. However, if you have malocclusion because the whole lower jaw is retracted, then jaw correction (orthognathic) surgery might be necessary. In the latter, the whole lower jaw and teeth are brought forward.
Is orthognathic surgery painful?
You will be asleep during jaw correction surgery, so you won’t feel any pain. After the procedure, you will likely experience some jaw pain. However, this can usually be dealt with using painkillers prescribed by your surgeon.
Does orthognathic surgery change your face?
Yes. Orthognathic jaw surgery can help alter your facial appearance. It can help your face appear more proportionate by fixing jaw alignment, and crossbite. It can also improve your facial profile.
Does orthognathic surgery change your lips?
Jaw correction surgery can help make your lips align and prevent teeth from showing when relaxed. It gives the lip and mouth a more proportionate appearance by bringing the lower and upper lips together.
Does your voice change after jaw surgery?
Orthognathic surgery might slightly influence the way you sound; however, it does not alter your voice. Jaw surgery can affect articulation and pronunciation. If you had problems pronouncing certain sounds (like “S”), then orthognathic surgery might solve the problem.
Is jaw orthognathic surgery permanent?
Yes. Orthognathic surgery is regarded as permanent. The shape of your jaw is changed forever. Nevertheless, in very rare cases, the original deformity might recur, necessitating revision surgery.
What are Risks and Complications of Corrective Jaw Orthognathic Surgery?
Jaw correction orthognathic surgery is a major surgery that involves bone cutting, soft tissue manipulation, bone grafting, tooth extraction, and the use of metallic plates.
Some of the rare complications that might occur after corrective jaw orthognathic surgery include:
- Wound infection
- Nerve injury
- Haematoma (blood collection)
- Problems with jaw movement
- Pain in the jaw joint
- Recurrence of the jaw deformity
- Need for further surgery
This is why Dr Maryam carefully plans her orthognathic procedures and carries extensive discussions with your dentist and orthodontist before the surgery.
Further Reading & Medical Sources about Corrective Jaw Surgery
- Malocclusion prevalence and orthodontic treatment need in central Anatolian adolescents compared to European and other nations’ adolescents
- Treatment classification of Class III malocclusion
- (PDF) Classification of Skeletal and Dental Malocclusion: Revisited
- Malocclusion and Orthodontics | Michigan Medicine
- Orthodontic Treatment of Malocclusion and its Impact on Oral Health-Related Quality of Life
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PLASTIC SURGEON SYDNEY
Dr Maryam Seyedabadi
Dr Maryam Seyedabadi has recently joined Dr Hunt’s practice in Edgecliff and is now available for consultations on a range of plastic surgery and cosmetic surgery for breast, body and face.
She is just one of the very few dually qualified Specialist Plastic Surgeons, completing both medical and dental degrees. This gives her a unique skillset and ability for face surgery, orthognathic & jaw surgery.
As a Sydney Female Plastic Surgeon, Dr Maryam offers surgery by women for women. She is supported in clinic & theatre by a completely female surgical team for those who prefer being operated on in a women-only or more female-friendly private hospital environment.