Jaw surgery

As its name suggests, jaw surgery refers to a procedure carried out on the jaw. There are several types of jaw surgery.

Jaw surgery is primarily used to address deformities that can’t be corrected with braces alone. In this instance, jaw surgery forms part of a wider orthodontic treatment plan.

Other reasons why jaw surgery may be needed can include correcting congenital defects and repairing damage caused by injury.

However, for the purpose of this page, we’ll be covering what to expect from an osteotomy.

When you choose a Circle Health Group hospital for your jaw surgery, you couldn’t be in safer or more experienced hands. We’re committed to helping our patients understand what is involved in jaw surgery, what to expect at each stage of the process, and what recovery from jaw surgery is like.

Every patient is unique and assessed on an individual basis, ensuring that our oral and maxillofacial consultants continually provide the very highest quality surgery, and the very best patient care.

Jaw surgery is performed with the purpose of addressing and correcting three things. These are:

• The function of your teeth and jaw, ensuring that they come together properly so that you can bite, chew and speak
• The appearance of your mouth and teeth, improving the symmetry of your face and ensuring that you look the best that you can
• The long-term health of your teeth and gums. This will minimise the risk of future oral health issues such as uneven wear and tear on your teeth, periodontal disease and more

There are a range of reasons why someone may be recommended to have jaw surgery.

In the case of osteotomies, the procedure is advised when it isn’t possible to correct your teeth and how they bite together with orthodontics alone. This is because the bones of the face and jaws are out of balance with one another.

In some cases, it’ll be necessary to remove one or more wisdom teeth before your osteotomy takes place. This is because wisdom teeth may get in the way of the new position that your jaw needs to take.

Your orthodontist or oral and maxillofacial consultant will advise you if you need to have wisdom teeth removed before your jaw surgery.

There are several different types of surgery.

Which you will need will depend on your individual circumstances and will be decided and explained to you at your consultation with your Circle Health Group oral and maxillofacial consultant.

Your procedure will be planned using the very latest CAD/CAM technology which enables the movement of your jaw to be planned with pinpoint accuracy, while ensuring that the plates that are created to support your jawbone as it heals will fit into place perfectly.

Maxillary osteotomy

Maxillary osteotomy refers to surgery that is performed on the upper jaw.

 A cut will be made through the gum above your upper teeth to gain access to the jawbone. The bone itself is then cut with a small saw, which enables it to be broken in a safe and controlled way.

Once the bone is broken, your oral and maxillofacial surgeon will be able to move the two pieces into a new and improved position, where it is secured in place using plates and screws. Finally, the incision is closed using dissolvable stitches and the jaws held in position using elastics rather than being wired.

Mandibular osteotomy

Mandibular osteotomy refers to the same surgery but performed on the lower jaw.

Bilateral osteotomy

A bilateral osteotomy is when surgery is performed on both jaws at the same time.

Surgery is performed under general anaesthetic, meaning that you’ll be asleep for the duration of the procedure.

The length of your surgery may vary depending on what is involved, but most procedures take between two and five hours. Your surgeon will be able to give you a more specific estimation.

As with most surgeries, it’s very helpful to understand what to expect from your recovery after jaw surgery before the procedure itself.

“Thanks to advances in the tools and techniques we use in osteotomies, the healing and recovery period is much better than it was even a few decades ago,” explains Dr Spencer Hodges, Consultant Oral & Maxillofacial Surgeon for Circle Health Group.

In total, it takes around six weeks for the jaw to heal following an osteotomy. During this time, the bones will fuse into their new position so that your face permanently retains its new shape and structure.

Most patients will only need to stay in hospital for one night, maybe two at most. This will enable your hospital team to monitor you immediately after your procedure and oversee the earliest part of the healing process.

They may also check the position of your jaw using an X-ray before you are discharged.

One of the biggest worries that patients have is that they will be in a lot of pain after their jaw surgery.

While it is normal to experience some discomfort, this can usually be controlled with a combination of co-codamol and ibuprofen, which will be prescribed by your surgeon.

You will usually only need to take this for the first few days after your surgery, after which time over-the-counter medications should be sufficient to keep you comfortable.

In addition to painkillers, you will also be prescribed antibiotics. These will help to minimise the risk of infection — something which is particularly important when you consider that the mouth is full of potentially harmful bacteria which could otherwise make infection likely.

Always follow the instructions provided by your surgeon and finish the course.

Swelling is a very normal part of the recovery process following jaw surgery and is the body’s natural response to the trauma it has experienced.

While the swelling will primarily affect your jaw, it can spread into the rest of the face and neck. You’ll be prescribed anti-inflammatory medications which will help to control it and the discomfort that it causes. However, it will take some time to disappear completely.

“About half of the swelling will disappear 2 weeks after your surgery, and 90% by 6 weeks post-procedure”, explains Dr Hodges. “However, the final 10% of residual puffiness, which will probably only be noticeable to people who know you well, could take up to 6 months to fully disappear”.

As you may expect, you’ll need to eat a little differently in the days and weeks after your surgery, at least until your mouth is fully healed.

It’s essential that you adjust your diet as recommended by your surgeon as this will minimise the risk of post-surgery complications and pain that could occur by making the mouth and jaw work too hard while it is healing. This dietary adjustment is broken down into 3 stages.

• Stage 1 – for the first 2 weeks after surgery, you should have a purely liquid diet. Some of the things that you will be able to enjoy include smoothies, custard, soup and yoghurt
• Stage 2 – following stage 1, you should spend the next 4 weeks sticking to a non-chew diet. This means that you can eat foods with some solidity, but that don’t need to be chewed and can be swallowed whole. Examples include very soft pasta, scrambled or poached eggs and mashed potato
• Stage 3 – finally, you’ll be able to gradually start introducing solid foods back into your diet

You’ll still need to maintain a robust oral hygiene routine in the days and weeks after your jaw surgery. This will help to ensure that your teeth and mouth remain clean, and that your risk of infection remains low.

It will also help preserve the condition and appearance of your teeth. Unsurprisingly, your mouth will be swollen and sore, so you’ll need to take extra care when brushing and flossing.

Here are some tips for cleaning your teeth after jaw surgery:

• Use a soft-bristled brush with a small head. This will be easier to manoeuvre, and the bristles will be gentler on your gums.
• Take care not to brush on any areas where there are stitches until they are fully dissolved.
• You’ll be advised to rinse your mouth with warm, saltwater for at least a few minutes up to 5 times a day, for up to a week following your surgery. This will help keep your mouth clean and hygienic and encourage healing.

As with any surgery, you’ll need to take some time off of work or other activities to heal and recover. Exactly how much time will depend on the type of work you do and how quickly you heal.

However, most people are recommended to take between two and three weeks off, perhaps longer if you have a very physical job. Always listen to the advice provided by your surgeon.

Every surgery comes with a small degree of risk, and at your consultation, your Circle Hospital oral and maxillofacial consultant will take steps to determine that these risks are as low as possible. Nevertheless, they have a duty of care to ensure that you are made fully aware of what these risks are.

The main risk of jaw surgery is damage to the nerves that serve the mouth and jaw. This nerve damage is usually temporary, but in 10-20% of cases can be permanent, causing numbness in the jaw and lip. The risk of nerve damage is much higher in the lower jaw than in the upper jaw.

Surgeons are also keen to make patients aware that there is a risk of teeth and jaw recession. This is where the teeth and jaw start to go back to their original position. This can happen if you don’t wear the retainers that will be provided to you at the end of your treatment plan.

Patients who undergo jaw surgery should be made aware of the general risks associated with surgery, which include bleeding, bruising and infection.

Does jaw surgery change the shape of your face?

While aesthetic improvements are one of the main purposes of jaw surgery, many patients are still unprepared for quite how different they could look after their procedure.

Every patient is different, but if your jaw surgery involves quite significant movement, it could also have a significant impact on the shape of your face and your appearance in general.

Your surgeon will pay close attention to your facial aesthetics at the time of your consultation, ensuring that the procedure won't only correct issues with your bite, but will also enhance the appearance of your face by making sure it is as symmetrical as possible. 

Does jaw surgery leave scarring?

“One of the most common questions that I am asked is whether or not patients will have scarring after jaw surgery,” says Dr Hodges.

He continues, “All of the incisions made during jaw surgery are done inside the mouth. This ensures that patients do not experience any visible scarring as a result of their procedure”. 

Your surgeon and orthodontist will want to monitor the progression of your recovery. Once you are discharged after your procedure, you’ll be asked to return for your first post-surgery review within the next two weeks.

 You will also be seen by your orthodontist around this sort of time, who will carry out any necessary treatment, such as helping to train your bite with elastics, or changing your brace.

Your second review will be carried out around six weeks after your jaw surgery.

There are various ages at which it is possible to get jaw surgery. The most optimal is shortly after the jaw has finished growing, usually in the late teenage years or early 20s.

However, every patient is assessed on an individual basis, and it may be possible to have jaw surgery much later if it is needed. “The oldest patient I have performed an osteotomy on was in her 70s. The procedure and recovery went very well”, says Dr Hodges.

In fact, with more patients than ever considering adult orthodontics to correct functional or aesthetic issues with their teeth, mouth and jaw, there are now plenty of people in their 30s and 40s undergoing osteotomies as part of their treatment programme.

If you aren’t sure if you are a suitable candidate for jaw surgery, we recommend that you schedule a consultation with a Circle Health Group Hospital.

Many people are surprised to learn that the plates and screws that are used in an osteotomy are only essential as part of the healing process, holding the bones in their new and improved position while they heal.

This takes around six weeks — after which, the plates and screws are redundant, but can safely remain in place.

That’s because they are made from titanium, which is biocompatible, meaning that the body won’t reject them. You won’t be able to feel them and you don’t have to worry about them setting off alarms at airports!

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to fit your routine
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Support by the same compassionate clinical team from beginning to end
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.