Orthognathic Surgery

Orthognathic surgery is a procedure that corrects problems with the position of your jaw bones. If your upper jaw, lower jaw, or both are not properly aligned, this surgery can help restore the way your teeth come together, improve your breathing, and bring better balance to your facial appearance.

This guide explains what the procedure involves, who it’s for, how to prepare, and what to expect during recovery.

What Is Orthognathic Surgery?

Orthognathic surgery repositions the jaw bones to correct structural problems that braces alone cannot fix. While orthodontic treatment moves teeth, this surgery addresses the bones themselves.

These jaw problems can develop during growth (when the upper and lower jaws grow at different rates), or they can result from an injury. In either case, the goal is to place the jaws in the correct position so your bite works properly and your face is in better balance.

The procedure is typically a team effort between an oral and maxillofacial surgeon and an orthodontist. Your specific outcome will depend on your diagnosis, the surgical technique used, and how your body heals.

When Is Orthognathic Surgery Considered?

Your doctor may recommend orthognathic surgery if you have jaw problems that affect how you chew, speak, breathe, or sleep — and these problems cannot be resolved with braces alone.

A full evaluation is always done first, including X-rays, dental impressions, and a functional assessment of your bite. Surgery is only considered after this thorough review.

Common Reasons for Jaw Surgery

Jaw Misalignment or Asymmetry

When the jawbones are not properly aligned, the muscles in your face have to work harder to compensate. This can lead to chronic jaw discomfort, uneven wear on your teeth, and difficulty chewing. Jaw misalignment is often related to how the bones grew during childhood, and may be influenced by genetics.

Bite Problems (Malocclusion)

Malocclusion means your upper and lower teeth do not come together properly. Mild bite issues can often be corrected with braces. But when the underlying cause is the position of the jaw bones — such as with a significant underbite or open bite — surgery may be needed to correct the foundation first.

Beyond the functional side, a severe bite problem can also affect how your facial profile looks, depending on how far the jaw is out of position.

Jaw Injuries and Birth-Related Conditions

A jaw fracture from an accident that did not heal in the correct position may require surgical correction to restore stability and proper function. Similarly, some people are born with differences in jaw size or shape — such as those related to cleft palate — that affect breathing, speech, or chewing.

In these cases, jaw surgery is often one part of a longer treatment plan involving multiple specialists.

At a Glance: Common Indications for Jaw Surgery

How Do You Prepare for Orthognathic Surgery?

Preparing for corrective jaw surgery is a process that takes time — usually between one and two years. It involves two main stages: orthodontic preparation and surgical planning.

Pre-Surgery Orthodontics

Before surgery, you will likely need to wear braces for 12 to 24 months. During this phase, the orthodontist moves your teeth into the correct position within each jaw bone — not into a position that compensates for the jaw misalignment.

This is an important distinction. Your bite may actually look and feel worse during this stage, and that is completely expected. The teeth are being positioned so that once the jaw is moved surgically, everything lines up correctly.

Surgical Planning and Imaging

Once your orthodontic goals are met, surgery is scheduled. Your surgeon will use advanced 3D imaging (called Cone-Beam CT, or CBCT) to build a virtual model of your skull. This allows the surgical team to plan every jaw movement digitally before setting foot in the operating room — improving precision and safety.

Medical Evaluation and Consent

You will also have a full medical evaluation to confirm you are fit for general anesthesia. Before any procedure, your surgeon will walk you through every stage of treatment, expected recovery timelines, and potential risks — including infection and temporary changes in sensation. You will have plenty of time to ask questions.

What Happens During Surgery?

Orthognathic surgery uses controlled bone-cutting techniques (called osteotomies) to carefully reposition the jaw bones in three dimensions. The procedure is performed under general anesthesia.

• Upper Jaw (Maxillary Osteotomy): The upper jaw can be moved forward, backward, or tilted to correct an open bite or reduce a gummy smile.
• Lower Jaw (Mandibular Osteotomy): The lower jaw is adjusted to correct a protruding or receding jaw and improve bite alignment.
• Fixation: Once the jaws are repositioned, small titanium plates and screws hold the bones in their new position. These are designed to stay in your body permanently and are completely safe.

The exact procedures performed will depend on your individual diagnosis and treatment plan.

Chin Surgery (Genioplasty)

Genioplasty is a procedure that adjusts the position of the chin bone. It is often performed alongside jaw surgery to address proportional concerns in the lower face. Unlike a chin implant, a genioplasty uses your own bone — moving it forward for a more defined chin, or backward if the chin is too prominent. The decision is based on a detailed assessment of your chin, lower lip, and neck relationship.

Dental Implants Alongside Jaw Surgery

In some cases, jaw surgery is combined with dental implants to replace missing teeth. Implants act as artificial tooth roots placed in the jawbone. When combined with corrective jaw surgery, this approach can significantly improve chewing ability. Success depends on bone quality, careful planning, and maintaining good oral hygiene long term.

What Is Recovery Like?

Recovery from orthognathic surgery happens in stages and requires patience. Here is what most patients can expect.

The First Few Days

Swelling and bruising are normal and expected after surgery. Swelling usually peaks within 48 to 72 hours and then gradually reduces over several weeks. Pain is manageable with prescribed medication and cold therapy.

Numbness and Sensation Changes

It is common to experience temporary numbness or tingling in your lips, chin, or cheeks. This happens because the nerves near the surgical areas are affected during the procedure. Sensation usually returns, but the timeline varies — it can take anywhere from a few weeks to several months.

Activity Restrictions

You will need to avoid strenuous exercise and heavy lifting for several weeks after surgery. This allows the bone segments to begin healing properly without added stress or risk of displacement.

Eating After Surgery: Dietary Guidelines

Because the jaws need to stay stable while healing, you will need to follow a careful diet in the weeks after surgery.

Here is how it typically progresses:

1. Phase 1 — Liquid Diet (Weeks 1–2): Only liquids are allowed. No jaw movement. Nutrition comes from smoothies, broths, protein shakes, and juices.
2. Phase 2 — Soft Foods (Weeks 3 onwards): As healing progresses, soft foods that require little to no chewing can be introduced — such as mashed potatoes, thick soups, and yoghurt.
3. Phase 3 — Return to Normal Eating: Harder foods are only reintroduced after your surgeon confirms through imaging that the bones have healed sufficiently. This typically happens several months after surgery.

Potential Benefits and What to Expect

Orthognathic surgery is designed to address deep-seated jaw problems that affect your daily life. When the procedure is appropriate for your condition, the potential benefits include:

• Improved chewing efficiency and bite coordination
• Clearer speech and easier mouth movement
• Better breathing, particularly during sleep, for those whose jaw position was affecting the airway
• A more balanced facial appearance as a natural result of correcting the skeletal structure

It is important to have realistic expectations. The results depend on your individual anatomy, the severity of your condition, and how your body heals. Any aesthetic improvements are a byproduct of correcting the jaw to a healthier, more functional position — not a cosmetic goal in themselves.