Orthognathic (Jaw) Surgery
Our jaw is a critical component of our face. It’s much more than simply a tool for chewing. A healthy, aligned jaw plays an important role in proper bite alignment, speech, airflow, and facial symmetry.
When there are congenital problems with a person’s jaw, or if earlier trauma was not correctly treated, the jaw may be out of alignment, which can lead to a variety of functional and cosmetic issues.
At Austin Cosmetic Surgery, both Dr. Michelle Carbret-Carlotti and Dr. Albert Carlotti have specific training and expertise in orthognathic surgery, jaw surgery, to correct these problems for our patients.
What is Orthognathic Surgery?
Orthognathic surgery is the clinical term for corrective jaw surgery. This involves one or more surgeries to move the bones of the upper or lower jaws, or both. The goal of these surgeries with the Drs. Carlotti is proper alignment of the upper and lower jaw. To achieve this, the jaws are lengthened or shortened, moved up or down, in or out. This corrects the alignment of the jaws, which improves the way they function and fit together.
Can Orthognathic Surgery Correct Bite Discrepancies and Facial Imbalance?
These are typically the main two reasons behind the need for these surgeries with the Drs. Carlotti. Of course, many misaligned bites also show up in facial imbalance. In the vast majority of patients, the use of orthodontics is involved both before surgery and after surgery. Before surgery, the orthodontics will align the teeth independently in each jaw. Once the jaws have been repositioned with surgery, another round of orthodontics will complete the alignment of the teeth into the optimal bite. We work with orthodontists for this aspect of these treatments.
Once the surgery and the orthodontics are complete, the patient will have a perfectly aligned bite. His or her jaw will now be either pulled back (if it was protruding and causing an underbite) or brought forward (if it was recessed and causing an overbite). A weak chin will be proportional.
When is Orthognathic Surgery Necessary?
Jaw misalignment is often quite obvious, showing itself in underbites and overbites. But there are other subtler effects related to this misalignment. Jaw surgery at Austin Cosmetic Surgery could be a great option to:
- Make biting and chewing easier
- Alleviate problems with swallowing
- Correct speech issues
- Correct bite fit or jaw closure problems
- Correct facial imbalance, such as small chins, underbites, overbites, and crossbites
- Improve the ability of the lips to close comfortably
- Relieve temporomandibular joint disorder caused by a misaligned bite
- Repair issues from prior injury or birth defects
- Correct alignment leading to obstructive sleep apnea
Who is a Good Candidate for Jaw Surgery?
To have orthognathic surgery the patient’s jaws must be fully developed. For females, this occurs around age 14 to 16. For males, it occurs between the ages of 17 and 21.
What are the Different Types of Jaw Surgery?
The three main types of Jaw Surgery is Upper, Lower, and Chin Surgery. These different types of surgery help correct specific problems within different areas of the jaw to create the proper alignment necessary for speech, facial balance, and much more.
Upper Jaw Surgery
Upper jaw surgery can correct:
- Significantly receding or protruding upper jaw
- Too much or too little of the teeth showing
- Open bite (where the front teeth don’t reach each other)
- Reduced facial growth of the middle of the face
Lower Jaw Surgery
Lower jaw surgery can correct:
- Receding lower jaw
- Protruding lower jaw
If the chin is overly small (which often accompanies a severely receded lower jaw), Drs. Carlotti may also perform chin surgery during the same surgical session. Here a piece of the chin bone is taken from the front of the jaw and it is moved forward and secured in place with plates and screws. A bone graft will be used to fill the space.
What are the Risks Involved with Jaw Surgery?
These are safe procedures when done by an experienced team such as Dr. Michelle Carbet-Carlotti and Dr. Albert Carlotti, both of whom have extensive specialized training in orthognathic surgery.
Of course, this is surgery, so there are risks, such as infection, blood loss, and possible reactions to anesthesia. Specific to jaw surgery, these are the risks:
- Jaw fracture
- Relapse of the jaw to the original position
- Problems with bite fit
- Jaw joint pain
- Need for additional surgery
- Need for root canal therapy on teeth affected by trauma
- Loss of a portion of the jaw
- Nerve damage
- Periodontal problems
These are rare risks when dealing with experienced surgeons and orthodontists.
How is Orthognathic Surgery Performed?
These surgeries are performed with the patient under general anesthesia. Afterward, the patient may be sent home or may stay a night in the hospital.
Prior to the procedure, we use a combination of facial x-rays and 3D imaging to plan the movement of the jaws into the correct positions. We share this with you so you can understand what we’re going to do and the extent of your overall treatment.
In most cases, the incisions can be made within the mouth, so there aren’t any facial scars on the chin, jaw, or mouth area. Once we gain access to the underlying jawbones, they are cut as necessary to move them into the correct position. To keep them in place, we use tiny bone plates and screws. Made of titanium (the material used for dental implants), these anchoring devices will become integrated into the bone structure over time.
If the lower jaw needs to be moved forward, we may need to add bone graft where the bone is cut and brought forward. For the graft, we usually take bone from the hip, leg, or rib.
How Long Does Orthognathic Surgery Take?
If Dr. Carlotti is working on just one jaw, these surgeries typically take from 1-2 hours. If both jaws are involved, and maybe the chin, the surgery can take from 3-5 hours.
What is Recovery Like After Jaw Surgery?
You would assume there would be a lot of pain associated with orthognathic surgery. After all, the jawbone is cut. But patients often tell us their post-surgical discomfort was much less than they anticipated. There will be swelling and bruising. Younger patients tend to swell more and bruise less, while the opposite is true of older patients. Swelling can return at times, especially late in the day after being on your feet a lot, for months.
Obviously, you’ll be on a fully soft diet for a period of time. This will vary depending on the difficulty of your surgery, but the first 3 weeks will be liquids only. You’ll also have to avoid strenuous exercise or any lifting that raises the blood pressure to your face.
Your initial healing typically takes about 6 weeks, but complete healing will take up to 12 weeks. After your initial healing, the orthodontist will finish the alignment of your teeth.
How Long Before I Can Chew Normally After Orthognathic Surgery?
After about 6 weeks, you can progress to a soft-chew diet. This means dishes should be soft or cut into small pieces. Think of the consistency of fish. You still don’t want to place pressure on the jaw. After 6-8 weeks you can progress to more normal chewing, but you’ll still want to avoid pizza, apples, tough meats, and the like until at least 3 months after your surgery.
Schedule a Jaw Surgery Consultation Today!
To learn more about our Orthognathic procedures, please call us at 512.688.8000 for our Lakeway, TX office and 480.947.7700 for our Scottsdale, AZ office to schedule a consultation. Our team at Austin Cosmetic Surgery looks forward to hearing from you!