Orthognathic Surgery — Procedure Guide, Recovery & Risks | MyMedicPlus

Orthognathic surgery (corrective jaw surgery) repositions the upper jaw (maxilla), lower jaw (mandible), or both to correct skeletal discrepancies causing malocclusion, facial imbalance, obstructive sleep apnoea, or difficulty chewing and speaking that cannot be resolved by orthodontics alone.

Indicated for skeletal Class II (retrognathia) or Class III (prognathism) malocclusion, open bite, crossbite, facial asymmetry, obstructive sleep apnoea with jaw contribution, cleft palate secondary deformity, and facial trauma sequelae after growth completion around age 17–21.

Surgery follows 12–18 months of pre-surgical orthodontics to align teeth within each jaw. Under general anaesthesia via nasotracheal tube, Le Fort I osteotomy repositions the maxilla; bilateral sagittal split osteotomy (BSSO) advances or sets back the mandible. Titanium plates and screws provide rigid fixation without jaw wiring in most cases.

Significant facial swelling peaks at day 3–5 and resolves over 4–6 weeks. A liquid and soft diet is maintained for 6–8 weeks. Post-surgical orthodontics fine-tunes occlusion over 6–12 months. Full bony healing and nerve recovery may take 9–18 months.

Risks include inferior alveolar nerve paraesthesia (temporary in 50–70%, permanent in 5–10%), condylar resorption (rare), relapse requiring re-operation, infection, non-union, and airway swelling. Plate removal is needed in under 5% due to hardware irritation.

Orthognathic surgery achieves stable skeletal correction in over 90% of patients. Functional improvements in chewing, speech, and sleep apnoea severity are well-documented. Patient satisfaction scores are consistently high, with improved self-esteem and facial aesthetics.