Corrective Jaw Surgery

What Types of Problems Does Jaw Surgery Fix?

There are many reasons to choose corrective jaw surgery at Carolinas Center for Oral & Facial Surgery. We can address common problems: malocclusion (underbite or overbite), crooked jaw, protruding jaw, open bite, and jaw asymmetry. These issues can cause a variety of problems, such as:

• Difficulty Chewing, Biting, or Swallowing
• Breathing Issues 
• Sleep Apnea
• Chronic Temporomandibular Joint (TMJ) Pain
• Headaches 
• Facial Dysfunction 
• Excessive Teeth Wear 

Any of these jaw issues can exist at birth or develop after birth as the result of genetics, environmental influences, or trauma to the face. No matter what causes your jaw problems, the team at Carolinas Center for Oral & Facial Surgery can provide efficient, reliable, and predictable results.

Getting Started with Corrective Jaw Surgery

The first step to achieving beautiful results with corrective jaw surgery is scheduling a consultation with your surgeon at Carolinas Center for Oral & Facial Surgery. 

During your consultation, you and your doctor will discuss your jaw problems and treatment goals, review your medical history, perform an oral evaluation, and take all the imaging necessary to build an ideal treatment plan.  

Your initial consultation is also the ideal time to discuss any hesitations or concerns you have with the procedure., including the procedure risks, benefits, alternatives, and costs. All in all, you can expect your initial corrective jaw surgery consultation to take around two hours. 

After your consultation, we work with your orthodontist to create a personalized treatment plan that helps you achieve your overall goals. Once we finalize your treatment, our practice will contact your insurance provider to obtain authorization and discuss the financial details with you. 

Furthermore, depending on your treatment plan, it may be necessary to prepare your mouth for surgery by aligning your teeth with braces or retainers. When your orthodontist gives you the all-clear, we will schedule a return visit and set a date for your surgical procedure. 

The Corrective Jaw Surgical Procedure

Once your teeth are optimally aligned and prepared for corrective jaw surgery, it is time to schedule your pre-surgical appointment. At this visit, our team will take comprehensive facial x-rays and use state-of-the-art computer video imaging to create a virtual model of your teeth and facial skeleton. 

Computerized treatment planning minimizes treatment times, decreases your recovery period, and improves your surgery’s overall efficacy and accuracy. Furthermore, with this advanced technology, we can show you in great detail how your jaw will be improved and even give you an idea of how you’ll look after surgery. 

When your surgery date arrives, it will take place at our accredited surgery center, and we will place you under anesthesia, which maximizes your safety and comfort during the procedure. 

After anesthesia is administered, your surgeon will reposition your jaw to suit your individual needs. Depending on your treatment plan, your doctor can add, reshape, or remove the bone. Your surgeon may also use screws, surgical plates, rubber bands, and wires to secure your jaws in their new locations. In most cases, incisions are made inside your mouth to reduce noticeable scarring.

Recovering from Corrective Jaw Surgery

Following your corrective jaw surgery, you will likely experience facial swelling, bruising, and soreness. Facial swelling will peak around day two or three and then continue to subside within the first few weeks of your recovery. To minimize the swelling, we recommend you apply ice packs in intervals of twenty minutes on and off and keep your head elevated. To help with any discomfort, your doctor will prescribe you pain medication. 

You can expect your discomfort to improve with each passing week. After about one week of recovery, you will meet with your surgeon for a follow-up assessment that examines how your jaw is healing. 

Regarding your diet after corrective jaw surgery, you can expect to be put on a liquid diet for the first week and then a soft foods diet for around eight weeks or until your jaw heals. When on a liquid diet, we recommend broth, juice, and liquid protein drinks. No smoking is allowed during your recovery period, as this can significantly impact your body’s healing abilities. 

Generally, our surgeons recommend taking one to three weeks off from school or work. However, this depends on the extent of your surgical procedure. Your surgeon will discuss their recommendations with you in more detail at your pre-surgery appointment. 

The Facts Behind Corrective Jaw Surgery

If you experience persistent pain or discomfort in your jaw; if you are unhappy with the shape of your smile; then you deserve to know the facts about orthognathic surgery. Also known as corrective jaw surgery, this procedure can fix and alleviate speech problems, chronic jaw pain, under/overbite, obstructive sleep apnea, and many other conditions whose effects range from inconvenient to debilitating.  

Who Needs Jaw Surgery? 

One third of Americans have significant misalignment of their teeth. This can be caused by birth defects, environmental factors, or facial trauma, but is also simply a consequence of the fact that jaw growth is a gradual process. In some cases, upper and lower jaw bones grow at different rates, leading to asymmetry (for example, the upper jawbone is larger than the lower, or vice versa.) The resultant jaw misalignment may manifest as: 

- Severe Underbite: occurs when the lower jaw is larger than the upper jaw, linked with elevated risk of tooth decay and gum disease. 

- Severe Overbite: occurs when the upper jaw is larger than the lower jaw, may lead to serious problems with chewing. 

- Open Bite: occurs when bottom and top teeth do not touch when the mouth is closed, making it difficult to bite using the front teeth. 

In some cases, orthodontia alone can fix these problems. But in other cases, the asymmetry can be more severe, leading to serious symptoms such as difficulty chewing or swallowing; chronic jaw or TMJ pain; and even difficulty with breathing as in sleep apnea. If you experience any of these symptoms, and the misalignment of your jaw is negatively impacting your quality of life, then it’s time to explore the benefits of corrective jaw surgery. 

Consulting an OMS 

Due to the symptoms listed above (or other jaw-related complications), you have decided to explore corrective jaw surgery. Your next step is to consult with an OMS, who will use their expert knowledge of the jaw and face to locate the causes of any pain or discomfort and determine whether surgical intervention is the most advisable path forward. If they do recommend surgery, an OMS will work alongside the rest of your care team, particularly your orthodontist, to prepare you for the procedure. Many patients not only report less pain after such a surgery, but greater confidence in their appearance, leading to overall improvement in their lives. For this reason, an OMS will keep you as informed as possible throughout the process, using facial X-rays and computer-generated facial scans to show what you can expect after the procedure. 

Corrective Jaw Surgery: What to Expect 

This procedure, performed by your OMS, is usually done under general anesthesia. The surgeon manipulates your jawbone and moves the bones into their new position. They then secure the bone with tiny screws, plates, and rubber bands, which over time are integrated into the bone structure. In other cases, additional bone is taken from elsewhere in the body, such as the hip or ribs, and added to the jaw using screws. Examples of common procedures include: 

- Maxillary Osteotomy: This is a surgery done to correct abnormalities in the upper jaw, or maxilla. The OMS adjusts the maxilla or removes excess bone so that it fits properly with the lower jaw, or mandible. This can alleviate problems like overbite, crossbite, open bite, or midfacial hypoplasia. 

- Mandibular Osteotomy: This is a surgery done to correct abnormalities in the lower jaw, or mandible. The OMS manipulates the bone behind the molars so that the whole jaw can move as one, aligning the mandible with the maxilla. This can alleviate problems such as receding or protruding lower jaw. 

After surgery, there is a recovery period, during which your care team may again use orthodontics to complete the alignment of your jaw. During this time, your doctor may give you instructions such as avoiding strenuous activity, limiting the consumption of solid foods, and taking medications to manage pain. The result, after 6-12 weeks of healing, is your brand-new smile. 

The Benefits of Corrective Jaw Surgery 

For many people suffering from jaw pain and discomfort, corrective surgery can be life-changing. After receiving surgery, patients report less pain, less difficulty chewing, breathing, and swallowing, and improved confidence in their appearance. What’s more, corrective jaw surgery can help to treat serious conditions such as sleep apnea, which when left untreated can have life-threatening complications. For a happier, healthier life, talk to an OMS about corrective jaw surgery today. 

An Oral Surgeon's Overview of Corrective Jaw Surgery

Carolinas Center for Oral & Facial Surgery lies at the forefront of jaw surgery, leveraging the latest advancements in technology and expertise to deliver exceptional outcomes for their patients. The center’s oral and maxillofacial surgeons specialize in the diagnosis, treatment, and correction of complex jaw alignment issues. CCOFS offers patients cutting-edge solutions for addressing conditions such as asymmetrical jaws, sleep apnea, and orthognathic problems. Through a comprehensive and multidisciplinary approach, the oral surgeons at CCOFS work closely with patients to develop personalized treatment plans that combine orthodontics, surgery, and advanced diagnostic tools to achieve optimal outcomes and transform lives.  

 
CCOFS's oral and maxillofacial surgeons stay current with the latest techniques and best practices through ongoing education and training, allowing them to provide comprehensive solutions for complex jaw-related issues, participating in monthly case-sharing conferences, where they discuss complex cases, share techniques, and review pre- and post-operative evaluations to continually improve outcomes and assessments. These conferences foster collaboration, knowledge-sharing, and staying up-to-date on the latest developments in the field. “CCOFS is on the leading edge of the technology with jaw surgery and beta sites for virtual surgical planning, 3D printing bone graph, and in-house surgery models,” says Dr. Farrell. This commitment to innovation enables them to deliver exceptional patient care and life-changing outcomes.  

Corrective jaw surgery, also known as orthognathic surgery, is a complex procedure that involves correcting various conditions and issues related to the upper and lower jaws. These conditions can have a significant impact on a person's overall health, function, and appearance. For instance, some individuals may be born with conditions that cause their jaws to grow at different rates, leading to asymmetry, functional, and aesthetic problems. Others may experience mandibular retrognathism, where the lower jaw is smaller than normal, or prognathism, where the lower jaw is larger than normal.  

In some cases, patients may have congenital skeletal and dental malocclusions, where their jaw grows in an asymmetrical way from birth, making it difficult for orthodontics alone to correct the bite. Additionally, functional challenges such as overbite, underbite, or open bite can also necessitate jaw surgery. These functional challenges can lead to difficulties with eating, speaking, and even breathing. They can also cause temporomandibular joint dysfunction, myofascial pain, and sleep apnea.  

Corrective jaw surgery is a highly personalized procedure that requires a thorough evaluation of each patient's unique needs and anatomy. To develop a customized treatment plan, oral surgeons at CCOFS meet with their patients for a one-hour consultation, then conduct a comprehensive assessment that includes gathering medical history, performing a physical examination, and utilizing diagnostic imaging techniques such as radiographs and cone beam CT scans. With this data, surgeons can then determine the best course of action, that can improve oral health and enhance aesthetics.  

To address these issues, oral surgeons perform various types of jaw surgeries. Lower jaw surgeries include procedures such as Bilateral Sagittal Split Osteotomy (BSSO), Intraoral Vertical Ramus Osteotomy (IVRO), and Subapical Osteotomy. Upper jaw surgeries may involve multiple-piece Lefort Osteotomies. The key to successful jaw surgery is careful planning and execution. Patients have three options: leaving their bite unchanged, camouflage treatment, or a combined approach that involves orthodontic alignment followed by surgical correction. The latter often yields the most optimal results in terms of balance, proportion, symmetry, and function. Dr. Howell clarifies, “Different types of jaw surgeries are dependent upon the relationships of the jaws, the facial harmony and balance, the airway evaluation, and bit or occlusion the OMSs are looking to achieve. We will either move the upper or lower jaw, or a combination of both, moving the upper and lower jaw together. We can also move the chin for facial balance, as well as the base of the tongue forward to improve the airway.” By evaluating each patient's unique situation and developing a tailored treatment plan, oral surgeons can help their patients achieve improved oral health and overall well-being. 

“Different types of jaw surgeries are dependent upon the relationships of the jaws, the facial harmony and balance, the airway evaluation, and bit or occlusion the OMSs are looking to achieve. We will either move the upper or lower jaw, or a combination of both, moving the upper and lower jaw together. We can also move the chin for facial balance, as well as the base of the tongue forward to improve the airway.”

- Dr. Howell

 
The use of advanced imaging technology plays a vital role in the planning and execution of jaw surgery at CCOFS. This cutting-edge approach enables oral and maxillofacial surgeons to achieve precision and accuracy, resulting in faster procedures and more predictable outcomes. The integration of 3D scanning and virtual surgical planning allows patients to visualize the anticipated results of their surgery, providing greater peace of mind and increased satisfaction. This innovative technology also replaces traditional impression-taking methods, providing a more accurate and detailed understanding of the patient's anatomy. Dr. Howell notes that virtual surgical planning has become one of the most important parts of corrective jaw surgery in the last 20 years, as it allows oral surgeons to have the most advanced and accurate plan. By virtually planning and simulating the procedure before performing the actual surgery, oral surgeons can anticipate and address potential issues beforehand, refine their techniques, minimize potential complications, and ensure a smoother recovery for patients. This technology enables surgeons to significantly reduce the risk of errors and complications, providing patients with greater peace of mind. 

Oral surgeons at CCOFS prioritize patient comfort and confidence by addressing concerns and anxieties before surgery. By identifying and addressing concerns ahead of time, patients can feel prepared for a stress-free recovery and optimal outcomes. A long track record of safety in jaw surgery at CCOFS instills confidence, emphasizing the importance of proper medical clearance and screening. To further minimize risk, oral surgeons work closely with patients to ensure post-operative compliance, providing guidance and care to facilitate a smooth recovery. With extensive experience in performing 300-400 jaw surgery cases annually, patients can trust that their surgeon has the expertise to guide them through the process. 

In addition to office-based procedures, oral surgeons can perform complex surgeries in a hospital setting, where trusted anesthesia teams and hospital staff provide exceptional care and attention to detail. Dr. Dammling also notes that CCOFS is one of the largest groups in the nation that does outpatient and hospital-based jaw surgery. This allows for a range of benefits, including comprehensive care, advanced anesthesia techniques, and state-of-the-art facilities. CCOFS' skilled team of board-certified oral and maxillofacial surgeons has extensive experience in performing jaw surgeries. They stay up-to-date with the latest research and advancements in the field, ensuring patients receive the most effective and minimally invasive treatments. The ability to perform in-office surgery reduces the risks associated with hospitalization, such as infection and longer recovery times. Hospital-based services are also available for patients requiring more complex procedures or close monitoring. With CCOFS, patients can trust they are receiving expert care from a highly experienced team. 

Patient preparation is a crucial aspect of jaw surgery care at CCOFS. Pre-operatively, patients receive detailed instructions on medication management, pain control, dietary restrictions, and physical activity guidelines to minimize complications and ensure a smooth recovery. After surgery, patients receive ongoing support through regular check-ins and access to a dedicated phone number for questions and concerns. This personalized attention alleviates anxiety and uncertainty, enabling patients to focus on their recovery and achieve optimal outcomes. 

Oral and maxillofacial surgeons also educate patients on essential aspects of recovery, including nutrition, sleep, hygiene, and exercise. Patients receive dedicated care from their OMS, with follow-up appointments scheduled within 24 hours, one week, and one month. With outpatient surgery available at CCOFS, patients can recover at home, rather than in a hospital setting. The recovery process typically takes several weeks, with patients returning to daily activities by week three and resuming a normal diet by the end of the first month. Patients are advised to follow a soft food diet and take prescribed medication during this time. “A prepared patient is a healthier patient. That’s why we bring in our patients prior to surgery, making sure they have everything they need for recovery. As far as nutrition, we make sure they have the appropriate foods available to them during recovery, they have the appropriate tools they need to have a more comfortable experience after surgery. Risks are always going to be there, discomfort is always going to be there, but being able to mitigate that ahead of time is what makes us different,” says Dr. Thakkar. 
 

Oral and maxillofacial surgeons collaborate with orthodontists to ensure optimal alignment of the teeth, both pre- and post-operatively. This collaborative effort requires effective communication and sharing of patient records, notes, and recommendations between specialists. The importance of comprehensive care is emphasized by Dr. Farrell, who highlights the oral surgeons' direct involvement with orthodontists throughout all phases of surgery. This collaborative approach ensures that teeth are properly aligned before surgery and that any necessary adjustments are made post-operatively.  By working together, oral surgeons, orthodontists, and other specialists provide patients with exceptional care and support throughout their recovery process. 

At CCOFS, jaw surgery has the power to transform lives, and is evident in the remarkable stories of patients who have undergone these life-changing procedures. Dr. Thakkar recalls a young woman whose misaligned jaw was causing breathing difficulties and sleep disruptions. Following mandibular advancement surgery, she reported a significant improvement in her overall well-being, including enhanced breathing capacity and improved sleep quality. This comprehensive transformation not only boosted her self-esteem but also restored her ability to enjoy meals and sleep peacefully. Dr. Howell's patient, once hesitant to smile due to aesthetic concerns, gained newfound confidence after corrective jaw surgery. Dr. Franco's patient, who struggled with severe obstructive sleep apnea, could resume long-distance driving without fear of nodding off at the wheel after corrective jaw surgery. Dr. Dammling notes that patients with obstructive sleep apnea often experience a notable improvement in their overall health and functioning after surgery, characterized by increased energy levels and reduced daytime fatigue. Dr. Wessel recalls an impactful patient story of someone who struggled with self-image and was bullied in high school for having a jaw deformity, making it hard for him to speak and eat. The impact on his self-esteem led him and his family to work with Dr. Wessel to undergo jaw surgery. Afterwards, he transformed into a new, confident young man, whose outlook changed for the better. These case studies illustrate the profound effects of jaw surgery, which can have a lasting impact on patients' physical and emotional well-being. 

For the oral and maxillofacial surgeons at CCOFS, performing jaw surgery is a profoundly rewarding experience. The opportunity to alleviate patients' suffering and transform their lives is a constant source of inspiration and motivation. Seeing patients overcome the physical and emotional challenges associated with jaw misalignment, sleep disorders, and other conditions is a testament to the power of their expertise and dedication. Oral and maxillofacial surgeons take great pride in knowing that their work is not only improving patients' physical health but also enhancing their overall well-being, confidence, and quality of life. The sense of fulfillment that comes from witnessing patients' newfound ability to eat, sleep, and live comfortably is a reward that far exceeds the challenges of the surgical process itself. By taking a personalized approach to corrective jaw surgery, orthognathic surgeons can help patients achieve optimal alignment and function, enhancing their overall quality of life.