What is Corrective Jaw Surgery or Orthognathic Surgery?Dr Sanchaita Kohli
She had a beautiful face. But she would never smile with all her heart. Not for the camera, not with her friends, not around her little naughty nephew despite his hilarious shenanigans, not even in the mirror while she was alone. She hated her smile. All she could see was big, pale gums in spite of the delicate perfect teeth she had. People thought she was sad or arrogant, but she wanted to laugh and grin. She wanted to fix her smile but she didn’t know how.
Ever since my niece was diagnosed with a cleft lip and palate as a child, she has undergone rigorous treatment and surgeries more than I count. She is now in her teens and yet, she continues to look deformed with a sucked in face and she can’t bite properly with her crowded and tilted teeth.
My neighbour does not seem to have a chin. It’s like his face just blends into his neck. It makes him look like a bird. His wife constantly complains about his snoring to me. He is troubled but doesn’t know what to do about it. “My chin just never grew!”, he keeps saying.
I always knew there was something wrong with my face. But I could never put my finger on it. When I took selfies, I had a good side of the face and a bad side. But I never knew why. But whenever someone took a picture from me from the front, I hated it and deleted it immediately. Then my photographer friend pointed out that I have an asymmetrical face. One side of my face is bigger than the other. And now, that’s all I can see. When I see others around me, I feel different, and I want to blend in more. I wish I knew how.
My brother’s lower jaw is as if it is jutting out of his face. It makes him speak in a funny way, and he also has trouble chewing his food. He always feels conscious when meeting new people. His job requires her to constantly interact with a lot of people and make many presentations, and he is desperate to find a solution for his problems.
Do any of the above-mentioned situations feel familiar to you? Do you feel like you can closely identify with some of these features in your face? Do you wonder what the solution to these issues is, and how you can find expert guidance?
If your answer is “yes” to any of these questions, then you are a likely candidate for orthognathic surgery – or corrective jaw surgery in simpler terms.
Let me help you sum up the conditions which may require orthognathic surgery for correction:
- Dental mal-alignment that one cannot correct by orthodontics alone
- An excessively gummy smile
- A forwardly projecting upper / lower jaw or both
- Reduced chin projection
- An asymmetrical face
A repaired cleft palate
What is Corrective Jaw Surgery?
Orthognathic Surgery is a surgical procedure that is performed on the jaws to modify their position in a manner that improves their projection and symmetry. Having this surgery provides a balance to your face and facial proportions. It also helps to correct teeth and jaw relationships to provide better chewing efficiency and offer a more aesthetic jaw profile. This surgery is performed by skilled maxillofacial surgeons.
Have questions or want to get started? We are ready to help you with a smile!
What Orthognathic Surgery Can and Cannot Do
Before I get into the procedural aspect of this surgery, it is important for me to tell you what corrective jaw surgery can and cannot do. I think it is important for me to first address what this surgery cannot do, to dispel some preconceived notions and bring in some reality check.
What Orthognathic Surgery Cannot Do
- It cannot create a completely new face – please note, we are only repositioning the jaw to provide better balance to your face. While that will have a marked change on how you look, it will NOT give you entirely new features.
- Change your personality – your personality is basically inherent to you. In a nutshell, it is basically the sum-total of everything you have experienced till date. How you look is only but one part of it. While improved symmetry on your face can make you feel good and increase your self-esteem and self-confidence, it will not change who you are. You have to work on yourself for any specific personality changes you are looking for in yourself
What Orthognathic Surgery Can Do
- Improve the face profile and symmetry – in simpler terms, it will bring about an evenness to your face which will help with the aesthetic appeal.
- Improve your smile and lip projection – sometimes your mouth may not look the way it is supposed to because of the positioning of your jaw. When this is corrected, your smile will also improve greatly.
- Change the appearance of your nose – this is an indirect consequence of changing the position of your jaw. Once the jaw is positioned better, it changes the overall look of your face, including how your nose looks.
- Correct disturbed dental relationships and improve chewing efficiency – you may not even have realized that there was something wrong in the way you were able to chew. But by bringing the jaw into the correct position, this is a welcome change you are likely to observe.
- Make you appear more youthful, more feminine, or masculine, depending upon the procedure.
Basically, by working on the positioning of the jaw, this procedure impacts the look of the connected parts of the face as well, such as the lips, chin, neck and nose, and helps not just alter your looks as per your desire – in some cases, it also helps improve your lifestyle by correcting the flaws in your dental relationships.
How should you prepare for Corrective Jaw Surgery?
After your initial consultation, once it has been decided that you will undergo this procedure, there is a phase of comprehensive planning between you, your surgeon and your orthodontist, to get the best possible results out of the surgery.
- Discuss your aesthetic requirements with your surgeon – while this may sound basic, it is a very crucial step. Whether you are undergoing this procedure for cosmetic reasons, or to improve jaw function, you have a certain end result in mind. Describe to your surgeon realistically and in detail how you imagine yourself looking and feeling at the end of the procedure – this will help design the most appropriate final jaw profile for you. The best part is, that with considerable advances both in the medical field as well as in technology, doctors can now show you the prospective results through simulation software by performing a virtual surgery on your digital scans. The planning phase includes your approval of the design. Do not rush, give your approval only when you are completely satisfied with the outcome, given the constraints of your case.
- Orthognathic surgery moves hand in hand with orthodontic treatment. This is because when the position of the jaw changes, dental relationships also change. Just like diet and exercise both need to be a part of your weight-monitoring regime, similarly, the orthodontic treatment has to proceed simultaneously with the surgery.
- As with any other surgery, remember to discuss your complete medical history and any current illnesses and medication you are on, as well as any allergies that are identified. Same is the case with lifestyle choices such as alcohol and smoking. This knowledge will help your surgeon plan better.
- You must stop smoking at least two weeks before the surgery – no ifs and buts.
- Get an oral prophylaxis (scaling) 1 week before surgery. This helps to improve oral hygiene and surgical outcome and helps avoid common infections in the post-surgery phase.
How the Procedure Works
While the procedure itself may take 2 to 4 hours (this will depend upon the extent of the deformity, and whether one or both jaws require the correction and what types of movements are involved), it is performed under general anaesthesia since it involves separating the jaw bones from the facial bony architecture and repositioning it into a more aesthetic and functional pre-planned position. The jaws are then fixed into their new position using sterile titanium miniplates.
In case you are worried about scarring on your face because of face surgery procedure, rest assured, the entire surgery is done from inside the oral cavity. It therefore leaves you with no scars or stitches anywhere on the face.
Corrective Jaw Surgery at RG Aesthetics
At RG Aesthetics, we perform corrective jaw surgery with the most advanced and premium quality equipment and hardware. We use ultrasonic bone saws (piezosurgery) for bone cutting to prevent the risk of injury to vital nerves and teeth during surgery, making the entire treatment experience safer and more comfortable for the patient. Also, the fixation plates used are of supreme quality and steam sterilized to prevent any risk of infection.
We meticulously plan the treatment with you and jaw repositioning is planned down to the exact millimetre. We also use simulation surgery software to ensure that you are an integral part of the plan and witness to the potential surgical outcome. A visual outcome prior to the surgery itself better helps you approve the design that we come up with.
Most importantly, we have experienced and expert cosmetic and maxillofacial surgeons with a thorough understanding of facial aesthetics and functions as well as the diverse facial deformities.
You should be aware of the proper recovery protocol and follow all your doctor’s instructions.
- Depending on the extent of surgery, corrective jaw surgery may require a period of hospitalization up to 1-2 days.
- Bone surgery always causes some facial swelling, which is completely normal and may be observed for up to four weeks after the completion of the procedure. In case the swelling persists, please contact your surgeon to understand its cause and get the right course of treatment.
- In some cases, a period of jaw closure (intermaxillary fixation) may be required for up to 2 weeks. This varies from case to case, and your surgeon may advise this for you depending on your requirements.
- Avoid solid foods and heavy exercise for up to 4 weeks after the surgery. Get your surgeon’s go ahead before you resume either. Till then, a soft and liquid diet, and simple exercises like walks are your companions.
- We advise regular saline rinses to maintain wound hygiene. These are simple and not at all time-consuming and should not be neglected.
In some cases, you may feel a numbness of the lips and/or some nasal stuffiness. This is normal and usually temporary in nature. If they persist, please contact your surgeon.
Risks involved in Corrective Jaw Surgery
As with any other surgical or medical procedure, there are certain risks involved. Corrective jaw surgery entails permanently altering one’s facial skeleton and therefore, is a meticulously planned procedure. Error at any stage in the treatment can lead to complications and these must be accounted for by a seasoned and expert surgeon. Depending on the extent and type of jaw repositioning performed, this surgery may be accompanied by any of the following:
- Relapse – Some degree of relapse, or revert of the jaws to the original position is inevitable and accounted for during planning. However, an excessive relapse may be seen if the treatment has not been adequately planned or performed
- Temporomandibular Joint (TMJ) pain – faulty jaw fixation can lead to excessive loads on the jaw joints while performing the vital function of chewing. This must be prevented at all costs
- Loss of sensation over the lower lip – Post-surgery lower lip numbness is normally transient in nature. However, permanent loss of sensation may be seen if the nerve was injured during surgery.
- Tooth devitalisation – teeth must be protected during cutting of the jaws to prevent their injury and preserve their vitality
- Wound infection – This may specially happen if you do not follow recovery protocols but is also a possibility when the procedure has not been properly performed.
I hope I was able to clarify your doubts today. We are always there to help you with any queries, and only offer the best-in-class treatments and procedures.
Dr. Sanchaita Kohli
Oral and Maxillofacial Surgeon
Dr. Sanchaita Kohli is an Oral and Maxillofacial Surgeon with over 13 years of training and work experience at the country’s leading dental institute, Maulana Azad Institute of Dental Sciences, enabling her to plan and manage an extremely wide variety of craniofacial deformities, jaw diseases and facial trauma.