Cirugía Ortognática
- Orthognathic surgery repositions the jaw bones to correct structural problems that cannot be fixed with braces alone, including underbites, overbites, open bites, jaw asymmetry, and breathing issues related to jaw position.
- The total treatment involves three stages: pre-surgical orthodontics (12 to 24 months), the surgical procedure itself (performed under general anaesthesia), and post-surgical orthodontics (3 to 6 months).
- During the pre-surgical orthodontic phase, your bite may look and feel worse than when you started. This is expected, the teeth are being positioned so that after the jaw is moved surgically, everything aligns correctly.
- The surgery is performed inside the mouth. There are no visible external scars on the face.
- Recovery to basic daily function takes around 10 to 14 days. Full bone healing takes several months. A soft diet is followed for the first few weeks after surgery.
- Aesthetic changes, a more balanced facial profile, a more defined chin, reduced facial asymmetry, are a natural byproduct of correcting the jaw to a structurally sound position, not a primary surgical goal.
Orthognathic surgery corrects jaw bones that have grown out of proportion, out of alignment, or in the wrong direction. The result is a bite that works, a face that is in better balance, and in many cases a significant improvement in breathing, chewing, and speech. It is a substantial procedure that requires careful preparation, a team of specialists, and a genuine commitment to the full process.
It is also, for the patients who need it, one of the most transformative treatments in dentistry. The combination of functional and aesthetic change that orthognathic surgery can produce, better bite, improved facial symmetry, clearer airway, cannot be achieved through orthodontics alone when the underlying problem is the position of the jaw bones themselves.
This page explains what the surgery involves, who it is appropriate for, what to expect across the full treatment timeline, and how international patients typically approach it.
¿Qué es la Cirugía Ortognática?
Orthognathic surgery is a set of surgical techniques that reposition the jaw bones in three dimensions, moving the upper jaw, the lower jaw, or both to a new, anatomically correct position. Once repositioned, the bones are held in place with small titanium plates and screws that stay in the body permanently and cause no problems.
The surgery addresses the bones, not the teeth. This is the key distinction between what surgery does and what orthodontics does. Braces move teeth within the jaw bone. Orthognathic surgery moves the jaw bone itself. In most cases, both are part of the same treatment plan, done in the right sequence.
When a bite problem is caused by how the jaw bones have grown, moving the teeth within those bones only masks the problem. You can straighten teeth into a misaligned jaw, but the underlying skeletal discrepancy remains. Orthognathic surgery corrects the skeletal foundation, then the orthodontic finishing work gives the teeth their final position within that corrected foundation.
¿Cuándo se Considera la Cirugía Ortognática?
Surgery is considered when a jaw problem is significantly affecting function, how you chew, breathe, speak, or sleep, and cannot be corrected by orthodontic treatment alone. A full assessment is always done first, including clinical examination, X-rays, CBCT imaging, and a functional evaluation of the bite. Surgery is never the first step.
| Condición | Lo que significa | How surgery helps |
|---|---|---|
| Jaw misalignment or asymmetry | The upper or lower jaw is too far forward, too far back, or unevenly developed | Repositioning the jaw restores proper balance for chewing, breathing, and facial symmetry |
| Severe underbite | The lower jaw protrudes forward of the upper jaw | Moving the lower jaw back and/or the upper jaw forward corrects the bite relationship |
| Severe overbite | The upper jaw protrudes significantly in front of the lower jaw | Surgical repositioning creates proper upper-to-lower jaw relationship |
| Open bite | The front teeth don't meet when the back teeth are together | Rotating the upper or lower jaw closes the open bite that braces cannot address at the bone level |
| Jaw-related sleep apnea | A lower jaw that sits too far back narrows the airway during sleep | Moving the lower jaw forward opens the airway and may reduce apnea severity significantly |
| Jaw injury | A fracture that did not heal in correct alignment | Surgical correction restores jaw stability and normal movement |
| Birth-related jaw differences | Jaw size or shape differences present from birth, including cleft-related | Part of a longer multi-specialist plan supporting speech, chewing, and breathing long-term |
Is Orthognathic Surgery Right for You?
✅ Surgery may be appropriate if:
- Jaw bone growth is complete (typically age 17–21 depending on sex)
- Your bite problem affects chewing, breathing, or speech significantly
- Orthodontic treatment alone cannot correct the underlying jaw position
- You are in good general health and fit for general anaesthesia
- You are committed to the full treatment timeline of 18 to 36 months
- You have realistic expectations, function is the goal, aesthetics are a byproduct
❌ Surgery is not appropriate if:
- Jaw bone growth is not yet complete
- The bite problem can be adequately managed with orthodontics alone
- Active gum disease or significant uncontrolled dental disease is present
- General health conditions make general anaesthesia inadvisable
- Expectations are primarily cosmetic without significant functional indication
Orthognathic surgery requires that the jaw bones have finished growing. This is typically around 17 to 18 in females and 19 to 21 in males, though it varies between individuals. Operating before growth is complete risks the jaw continuing to move after surgery, which may require a second procedure. Growth completion is confirmed through sequential X-rays showing no further change over time.
Not sure if your jaw problem requires surgery? Contact our team to arrange a consultation with our oral and maxillofacial surgeon. A full assessment will clarify what treatment is appropriate for your case.
Request a Jaw Surgery ConsultationAssoc. Prof. Burak Cezairli, Oral & Maxillofacial Surgeon
"The patients who do best with orthognathic surgery are the ones who understand from the beginning that this is a long process. When someone comes to me expecting to have surgery and be done within a few months, that's a sign we need to have a longer conversation first.
The pre-surgical orthodontic phase alone takes one to two years. During that time, your bite may get worse before it gets better, and that is completely correct. The orthodontist is moving your teeth to where they need to be after the jaw is repositioned, not to where they look best now. Patients who don't understand this often become concerned or want to stop. The ones who understand it go through the process far better.
I also want to be clear about what surgery can and cannot do. If someone comes in primarily for cosmetic reasons, I'm going to tell them that honestly. If there is a significant functional problem, surgery may well improve both function and appearance together. But the surgical indication has to be functional. The aesthetic benefit is real and meaningful, it is just not the driver of the decision."
Assoc. Prof. Burak Cezairli, Oral & Maxillofacial Surgeon, DentAkademi
The Full Treatment Timeline
Orthognathic surgery is not a standalone procedure. It is the central stage of a treatment plan that spans 18 to 36 months in total. Understanding the full timeline before starting is essential.
Initial Assessment and Treatment Planning (1–2 months)
Clinical examination, dental impressions, X-rays, and CBCT (3D cone beam CT) imaging. The surgeon and orthodontist jointly plan the treatment: which jaw movements are needed, how much, in which direction. A virtual model of the skull is used to simulate the surgery digitally before it happens. Medical evaluation confirms fitness for general anaesthesia.
Pre-Surgical Orthodontics (12 to 24 months)
Braces or clear aligners are used to move the teeth into their pre-surgical positions. This is the most counter-intuitive phase: your bite may look and feel worse than before treatment started. This is correct and expected. The teeth are being positioned for where the jaw will be after surgery, not for where it is now. This phase cannot be rushed, surgery is not scheduled until the orthodontic goals are met.
Orthognathic Surgery (1 to 2 weeks in Istanbul)
The surgical procedure itself, performed under general anaesthesia. For most patients this involves 2 to 3 hours in theatre and a hospital stay of 1 to 3 days. Recovery to the point of returning home typically takes 10 to 14 days. International patients who have completed their pre-surgical orthodontics at home travel to Istanbul specifically for this stage.
Post-Surgical Orthodontics (3 to 6 months)
Once the jaw has healed and the bones have consolidated in their new position, orthodontic treatment resumes to fine-tune the tooth positions within the corrected jaw relationship. This is the finishing phase, and it typically goes much faster than the pre-surgical phase because the skeletal foundation is now in the right place.
Final Retention and Long-Term Review
Braces are removed and retainers are fitted to maintain the final tooth positions. Long-term follow-up appointments monitor the stability of both the skeletal correction and the orthodontic result. Most patients are stable by 12 to 18 months post-surgery.
What the Surgery Involves
Orthognathic surgery uses controlled bone-cutting techniques called osteotomies to carefully reposition the jaw bones. All incisions are made inside the mouth, there are no external facial incisions and no visible scars on the skin.
Upper Jaw Surgery (Maxillary Osteotomy / Le Fort I)
The upper jaw is separated from the skull along a carefully planned cut line and moved forward, backward, upward, or downward depending on what the plan requires. It can also be tilted or rotated to correct asymmetry. The most common indications are a recessed upper jaw, an open bite, or a gummy smile caused by upper jaw overgrowth. Once repositioned, the upper jaw is stabilised with titanium plates and screws.
Lower Jaw Surgery (Mandibular Osteotomy / BSSO)
The lower jaw is separated along both sides through a technique called a bilateral sagittal split osteotomy (BSSO). This allows the tooth-bearing front section of the lower jaw to be moved forward, backward, or rotated independently of the joint-bearing back sections. It is used to correct an underbite or overbite caused by lower jaw position, and to improve the airway in jaw-related sleep apnea.
Bimaxillary Surgery
When both jaws need repositioning, upper and lower osteotomies are performed in the same surgical session. This is the most complex combination and typically produces the most significant change in both function and facial appearance. It is also the most common approach for patients with severe skeletal discrepancies.
Cirugía de Mentón (Genioplastia)
Genioplastia adjusts the position of the chin bone and is often performed alongside jaw surgery to improve facial proportion in the lower face. Unlike a chin implant, which adds volume from an external device, genioplasty moves the patient's own bone, forward for a more defined chin, backward if the chin is too prominent, or vertically if the chin height needs adjusting. The decision is based on the relationship between the chin, lower lip, and neck, assessed through clinical measurements and imaging.
For International Patients: How the Istanbul Phase Works
Most international patients complete their pre-surgical orthodontic phase with a local orthodontist in their home country. They then travel to Istanbul for the surgical stage, stay for recovery, and return home to continue post-surgical orthodontics with their local team.
| Cuándo | Qué sucede | Where |
|---|---|---|
| Antes del viaje | Pre-surgical orthodontic records (X-rays, photos, digital scans) sent to DentAkademi for surgical planning review | At home (local orthodontist) |
| Día 1 | Arrival in Istanbul, VIP airport transfer, hospital admission preparation | Istanbul |
| Día 2 | Pre-operative assessment: imaging review, anaesthesia consultation, surgical consent | Istanbul |
| Día 3 | Orthognathic surgery under general anaesthesia (1 to 3 hours in theatre, hospital stay begins) | Istanbul |
| Días 4–5 | Hospital recovery: swelling management, liquid diet, pain management, nursing care | Istanbul |
| Days 6–9 | Discharge to hotel or apartment: rest, soft diet, daily check-in with surgical team | Istanbul |
| Day 10–12 | Post-operative surgical review, wound check, imaging confirmation | Istanbul |
| Day 14 | Return flight home (when cleared by surgeon) | Departure |
| After return | Post-surgical orthodontics continues with local orthodontist using DentAkademi clinical records | At home |
| 3–6 months later | Optional follow-up visit to DentAkademi for bone healing review and surgical outcome assessment | Istanbul (optional) |
We work closely with international patients' local orthodontic teams to ensure the pre-surgical preparation meets the criteria needed before surgery is scheduled. Patients provide us with their orthodontic records, which our surgical team reviews before confirming the surgical plan. We provide full post-operative documentation so the local orthodontist can resume treatment with complete clinical information.
On Realistic Expectations
"One of the most important conversations I have before surgery is about what the result will actually look like. Patients often come in with reference images from online, other people's before and afters, and want to know if they can achieve something similar. My honest answer is: possibly, but the result depends on your anatomy, not a reference image.
What surgery can do with certainty is correct a specific skeletal discrepancy that has been measured and planned. If your lower jaw is 10mm too far back, we can move it 10mm forward. What that does to your facial profile depends on your individual soft tissue response, which we can estimate but not guarantee precisely.
I also discuss nerve sensation with every patient before surgery. Temporary numbness in the lips, chin, or cheeks is common after lower jaw surgery. In most patients it resolves. In a small number, some change in sensation is permanent. This is not a complication we hide, it is something every patient signs informed consent for, because they need to know. A surgeon who doesn't raise this proactively is not one I would trust."
Assoc. Prof. Burak Cezairli, Oral & Maxillofacial Surgeon, DentAkademi
Recovery: What to Expect
The first 48 to 72 hours
Swelling peaks in the first 2 to 3 days and is significant. Bruising around the jaw, cheeks, and sometimes the neck is normal. Pain is managed with prescribed medication, most patients find it more manageable than anticipated, though discomfort is unavoidable. A liquid diet begins immediately after surgery.
Days 4 to 14
Swelling begins to reduce visibly, though it takes weeks to fully resolve. Most patients are able to speak reasonably clearly by day 4 or 5. Fatigue is normal and rest is important. Strenuous activity is avoided during this period. Most patients feel well enough to return to light activity and work by day 10 to 14.
Weeks 3 to 8
Progressive return to normal activities. Soft foods that require minimal chewing are introduced. Swelling continues to reduce but is not fully gone, significant residual swelling at week 3 is normal and not a sign that something is wrong. Temporary numbness in the lips or chin is common and usually begins to improve during this period.
Months 2 to 6
Bone healing consolidates. Imaging is used to confirm the bones have healed in the planned position before post-surgical orthodontics begins. Most patients return to a fully normal diet during this phase. The final facial appearance begins to emerge as residual swelling resolves completely.
Dietary guidelines after surgery
| Phase | Timeline | What you can eat |
|---|---|---|
| Liquid only | Weeks 1–2 | Water, broths, smoothies, protein shakes, juices, yoghurt drinks. No jaw movement required. |
| Soft foods | Weeks 3–6 | Soft foods requiring minimal chewing: mashed potato, thick soup, soft pasta, scrambled eggs, yoghurt, soft fish. |
| Progressive return to normal | Months 2–4 | Gradually increasing texture as confirmed by surgeon. Harder foods reintroduced when bone healing imaging confirms it is safe. |
| Normal diet | Months 4–6 onwards | Full unrestricted diet, confirmed after imaging review. |
Risks and Complications
Orthognathic surgery is a major procedure with a well-established safety record when performed by experienced surgeons in appropriate settings. Understanding the risks beforehand is part of making an informed decision.
- Temporary numbness or altered sensation in the lips, chin, or cheeks, caused by proximity of the surgery to sensory nerves. Resolves in most patients over weeks to months. Permanent changes in sensation occur in a small percentage of cases.
- Swelling and bruising, expected, peaks at 48 to 72 hours, resolves over several weeks.
- Infección, uncommon with prophylactic antibiotics and appropriate post-operative care.
- Relapse, partial movement of the jaw back toward its original position. Risk is minimised by proper pre-surgical orthodontic preparation and correct fixation technique. Post-surgical orthodontics further stabilises the result.
- Delayed bone healing, rare. Managed with extended dietary restrictions and monitoring.
- Airway considerations, specific to the immediate post-operative period. Managed in a hospital setting with appropriate monitoring.
- Anaesthesia risks, as with any surgery under general anaesthesia. Assessed during the pre-operative medical evaluation.
All risks are discussed in detail during the pre-surgical consultation. Informed consent is a formal part of the process, not a formality. Patients receive complete written information before any surgical commitment is made.
DentAkademi en cifras
Questions about whether your case is appropriate for orthognathic surgery, or how to coordinate the surgical phase with your existing orthodontic treatment? Contact our surgical team directly.
Contact Our Surgical TeamConsideraciones Prácticas para Pacientes Internacionales
Can I have the orthodontics done locally and only come to Istanbul for surgery?
Yes, this is the most common approach for international patients. Pre-surgical and post-surgical orthodontics are managed by your local orthodontist in your home country. You travel to Istanbul specifically for the surgical stage. We coordinate with your local team throughout and provide complete clinical records after surgery.
How long do I need to stay in Istanbul for surgery?
Most patients need 10 to 14 days in Istanbul for the surgical phase. This covers the pre-operative assessment, surgery, hospital stay, and the immediate post-operative recovery period before it is safe to fly home. Flying too soon after major jaw surgery is inadvisable and your surgeon will confirm the earliest safe departure date based on your specific recovery.
Will flying home after surgery be comfortable?
By day 10 to 14, most patients are well enough to fly, though comfort varies. Swelling is still present. Cabin pressure changes are generally tolerable. Adequate pain medication, hydration, and not being too rushed in transit are the main practical considerations. Your coordinator provides guidance before departure.
What documentation will my local orthodontist receive?
Full post-operative surgical records: pre- and post-surgical imaging, a surgical report detailing the movements performed, post-operative instructions, and the timeline for resuming orthodontic treatment. Your local orthodontist receives everything needed to continue your care without gaps.
Is a follow-up visit to Istanbul needed after surgery?
A follow-up visit at 3 to 6 months post-surgery is recommended for bone healing imaging and outcome assessment. In many cases this can be managed through your local dental team using the imaging guidance we provide, with remote review by our surgical team. If a physical return visit is warranted, we discuss this well in advance.
Preguntas frecuentes
Resumen
Orthognathic surgery is indicated when a jaw problem is significantly affecting chewing, breathing, speech, or sleep, and when braces alone cannot correct the underlying skeletal discrepancy. It is a major procedure requiring a committed treatment timeline of 18 to 36 months, combining pre-surgical orthodontics, surgery, and post-surgical orthodontics.
For patients who need it, the results are substantial and long-lasting. Functional improvement in chewing, breathing, and bite coordination, alongside the facial balance changes that come from correcting the skeletal foundation, cannot be achieved through any other treatment combination.
For international patients, the most practical approach is to complete orthodontic preparation with a local team, travel to Istanbul for the surgical phase (10 to 14 days), and return home for post-surgical orthodontics. DentAkademi provides complete clinical coordination with your local team throughout the process.
The decision to proceed with orthognathic surgery begins with an honest consultation, one that covers the full timeline, the realistic outcomes, and the risks, not just the best-case result. That conversation happens before any commitment is made.
Start With a Surgical Consultation
If you have been told you may need jaw surgery, or if you are already in orthodontic preparation and want to discuss the surgical phase, contact our oral and maxillofacial surgical team. We will review your records and give you a clear picture of what is involved for your specific case.
Request a Jaw Surgery Consultation
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