Treatments / Oral & maxillofacial surgery
Corrective Jaw Surgery
Some bite problems come from where the jaws sit, not from where the teeth sit, and no amount of orthodontics alone will correct them. Corrective jaw surgery repositions the upper jaw, lower jaw or both, planned together with the orthodontic treatment before and after.
Who this is for
- A jaw that is noticeably forward or back
- Facial asymmetry
- An open bite, or difficulty biting and chewing that braces alone will not resolve
- Some cases of obstructive sleep apnoea
What actually happens
- Records, scans and joint planning with the orthodontist
- Pre-surgical orthodontics, usually several months
- Surgery in hospital, under general anaesthetic
- Post-surgical orthodontics and review
Who plans it, and what to ask
Corrective jaw surgery is planned by two people working from the same records: the surgeon who carries out the operation, and the orthodontist who manages your braces. They agree first on where your jaws should end up, and every later step is planned around that.
Something worth knowing before you start: during the braces before surgery, your bite often looks or feels worse for a while. Over the years your teeth have tilted to make up for the way your jaws sit. The braces straighten them back, so the jaw difference shows more clearly until the jaws themselves are moved.
At the first consultation, ask whether the problem is in your teeth, your jaws or both, which jaw would be moved and why, roughly how long the whole treatment will take, and what the risks are in your case, numbness included. The cost is given to you in writing before anything starts, and you are under no obligation to go ahead.
One jaw or both
Single-jaw surgery moves either the upper jaw or the lower jaw. If the problem sits mainly in one of them, such as a lower jaw that is set well forward or back, moving that one may be enough.
Both-jaw surgery, also called double-jaw or bimaxillary surgery, moves the upper and lower jaws in the same operation. It is considered when both jaws contribute to the bite problem or to an uneven face, so that moving only one would not give a bite that works properly. It is a longer operation, and recovery usually takes a little longer too.
Which one suits your case is worked out from your records and the examination, not from a photo of your profile. If one is suggested over the other, ask why.
In hospital, and the first weeks after
The operation is done under general anaesthetic in hospital, at one of the hospitals where Dr Kuchu is a visiting consultant maxillofacial surgeon (Bhoomi Hospitals, Manikonda; Madhavanji Hospitals, Tukkuguda; Kondeti Hospital, Tukkuguda; and Wellness Hospitals, Begumpet), and you are told which one before admission. The stay is usually a few days. You go home once you are drinking well and the swelling and pain are under control.
At home it is a liquid diet first, then soft food for some weeks. If the upper jaw was moved, your nose may feel blocked for a while. You come back to the clinic for regular reviews, and the orthodontist takes over again once the jaws have healed enough.
For the first week or so it helps to have someone at home with you, mainly for meals and getting to appointments. Your surgeon will tell you what to expect in your own case.
If you are trying to work out whether braces alone could fix your bite, when corrective jaw surgery is considered explains how that decision is made and what the timeline looks like.
The operation is done by Dr. Bhargav Kuchu, in hospital, and the orthodontist for these cases is Dr. Jahnavi Rachamadugu.
Questions people ask
Will my jaws be wired shut after orthognathic surgery?
Usually not. The bone is held in its new position with small plates and screws, so in most cases the jaws are not wired together. Light elastic bands on the braces are often used for a while to guide the bite.
Will there be a scar on my face?
Usually not, because corrective jaw surgery is mostly done from inside the mouth. If your case needs any small cut on the skin, the surgeon will tell you beforehand.
Will my face look different afterwards?
It usually changes to some degree, because the position of the jaws shapes the lower half of the face. How much depends on how far the jaws are moved, so ask the surgeon to explain the expected change in your case before you agree to surgery.
Can corrective jaw surgery help with sleep apnoea?
In some cases, yes. Moving the jaws forward can open up the airway behind the tongue, but it is one of several treatments for obstructive sleep apnoea and is only considered after the condition has been properly assessed.
Does corrective jaw surgery hurt?
You are asleep under general anaesthetic for the operation itself. Afterwards there is soreness and swelling, which is managed with pain relief in hospital and at home and eases over the following weeks.
Related treatments
Braces & Clear Aligners
Metal braces, self-ligating braces and clear aligners, including Invisalign.
Facial Trauma & Jaw Fractures
Assessment and fixation of facial and jaw fractures, and repair of facial lacerations.
TMJ & Jaw Pain
Jaw joint pain, clicking, locking and dislocation, assessed before anything is done.