What It’s Really Like To Get Jaw Surgery

For many, orthodontic treatments that shift the teeth are enough to correct our bite. But, when orthodontia isn’t enough, corrective jaw surgery may be required. Formally known as orthognathic surgery, the procedure is used to correct pronounced underbites and overbites and improve facial symmetry. “Orthognathic surgery is necessary when the teeth and jaws do not align properly,” explains Douglas Monasebian, MD, DMD, a New York City-based board certified plastic and maxillofacial surgeon and assistant professor at the Mount Sinai School of Medicine. “Very often, when this surgery is performed, the facial features will also come more into harmony adding to a more aesthetic appearance.”

Here, we break down everything you need to know about the surgery and talk to patients about their experience.

What Does Jaw Surgery Involve?

Jaw surgery is often part of a larger treatment plan that includes fixed-bracket braces, wisdom teeth removal, and more to correct an underbite or overbite. Surgery tends to be part of that teeth alignment process. “Orthodontic treatment (braces) is performed both before and after the surgery,” Dr. Monasebian says. “The length of time in braces can be between one to two years, with the surgery occurring usually at the halfway point.”

Depending on the patient's needs, orthognathic surgery can be performed on the upper jaw (maxilla), the lower jaw (mandible), or both. “The surgeries may be performed together or separately,” he explains. “The decision for this is determined by both the surgeon and the orthodontist. The evaluation includes clinical photographs, x-rays, and dental models.”

The Anatomy of the Face & Jaw:

Needless to say, there are surgical and anatomic differences between upper (maxillary) and lower (mandibular) jaw surgery, but both procedures are, as Dr. Monasebian shares, “quite involved” (think: four to six hours of operating) and performed under general anesthesia in the hospital. Another similarity? “All incisions are placed inside the mouth, so, after the swelling resolves, there is no visible scarring on the face,” he says.

During the surgery, the surgeon will cut into the bone and realign the bone, teeth, and soft tissue into their correct position. The bone is fixed in place using a combination of metal plates and screws, which are usually permanent. The screws should fuse into your jaw bone over time. In some cases, bone may be collected from another part of your body (i.e. the hips or ribs) to aid in that fusion process or to alter the shape of the jaw bone. In this case, patients have a small incision where that bone tissue is collected.

Recovering From Jaw Surgery

Today, jaws are stabilized with small metal plates and screws, which means they do not have to be wired together for six weeks like they used to be. But recovery from jaw surgery still takes time, with patients generally needing to take several weeks off of work or school. While patients usually return home the day after surgery, it is recommended that they have a caretaker for the first couple of weeks. Pain, swelling, and discomfort are common — especially in the first seven to 10 days — and are treated with pain medication and antibiotics.

Patients receive specific post-operative instructions that encompass the first couple of months after surgery. They will vary depending on the provider and procedure, but your surgeon should provide specific information on what you can and can’t eat, oral hygiene, when to resume regular activity levels, and when to return to work or school.

“The surgical results are immediate in that the jaws are placed in their new and correct position at the time of surgery,” Dr. Monasebian says. “The final surgical result will become apparent when all the swelling resolves, which is mostly gone after several weeks.” The bones heal in approximately six weeks, at which point braces are applied. “There will be another year or more of braces to have the teeth align,” he adds.

Patient Perspective

Recovery from jaw surgery takes time, but knowing what to expect can make the process much more manageable. We asked two patients to share their experience healing from orthognathic surgery.

Noah, 27, Chicago

Noah had jaw surgery to correct an underbite and improve his side profile. He spoke to us about what it’s like to have the procedure and shared some of his tips to make recovery more comfortable.

Jeanie, 30, Los Angeles

Jeanie chose to undergo jaw surgery to change the look of her side profile, which was affected by a severe underbite. She had the surgery two years ago after undergoing orthodontic treatment for a year beforehand.

The Takeaway

Performed by an oral and maxillofacial surgeon (OMS) or plastic and reconstructive surgeon, orthognathic surgery can be a life-changing procedure to align the mouth, optimize facial proportion, and improve quality of life.