Corrective Jaw Surgeryin Long Island City, NY
Some bite problems go deeper than the teeth. Corrective jaw surgery addresses the underlying skeletal imbalance at the source, and with it, often more than patients expect.
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Corrective jaw surgery (orthognathic surgery) addresses skeletal imbalances that orthodontics alone cannot correct. When the jaws don't relate to each other properly, the downstream effects can touch nearly every aspect of daily life: how you chew, how you breathe, how you sleep, and how you speak. Surgery resolves these at the source rather than managing symptoms around them. The aesthetic changes are equally significant. Improved facial symmetry and a more balanced profile are common outcomes, and for many patients the results feel less like an enhancement and more like a correction. For the right patient, the impact on quality of life is hard to overstate.
Types of Corrective Jaw Surgery
LeFort I Osteotomy
The LeFort I is the standard procedure for repositioning the upper jaw. By making precise cuts through the bone above the teeth, the entire upper jaw can be moved forward, backward, upward, downward, or rotated to correct the bite and improve facial balance. It's one of the most commonly performed orthognathic procedures and forms the foundation of treatment for many patients with significant upper jaw discrepancies.
Sagittal Split Osteotomy (SSO)
The SSO is the standard procedure for repositioning the lower jaw. Cuts are made through the back portion of the jawbone on both sides, allowing the tooth-bearing segment to be moved forward or backward to correct an underbite, overbite, or asymmetry. It's frequently performed alongside a LeFort I when both jaws need repositioning, and is one of the most well-studied procedures in oral and maxillofacial surgery.
Vertical Ramus Osteotomy (VRO)
The VRO is an alternative to the SSO for repositioning the lower jaw, most commonly used to correct an underbite. Rather than splitting the back of the jaw, a vertical cut is made instead, allowing the lower jaw to be set back. It requires a period of jaw immobilization (wired shut) after surgery but avoids some of the nerve-related risks associated with the SSO, making it a preferred option in certain cases.
Genioplasty
A well-proportioned lower face makes a significant difference in overall facial balance and the confidence that comes with it. A genioplasty repositions the chin by cutting and moving the chin bone forward, backward, upward, downward, or at an angle to correct asymmetry. It's often performed alongside other jaw procedures to fine-tune the overall result, but can also be done as a standalone procedure when the chin alone is the source of imbalance.
Segmental Osteotomy
In some cases, moving the entire jaw as one unit isn't the most effective approach. A segmental osteotomy divides the jaw into two or more pieces, allowing each segment to be repositioned independently. This is particularly useful for correcting an open bite, leveling a tilted smile, or closing gaps between teeth as part of a broader surgical plan. It requires careful coordination with orthodontic treatment to ensure the teeth are properly positioned before and after surgery.
Surgical Palatal Expansion (SARPE)
The upper jaw is made up of two halves that fuse together in early adulthood. Before that fusion is complete, orthodontic expanders can widen the palate gradually. In skeletally mature patients where traditional expansion is considerably less predictable, a surgical procedure can separate the two halves of the palate to allow controlled widening.
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FAQs
What conditions does corrective jaw surgery treat?
Corrective jaw surgery addresses skeletal discrepancies that straightening the teeth alone cannot resolve, and candidates generally fall into one of three categories:
- Patients with a functional complaint such as difficulty chewing or articulating speech, often from a severe underbite, overbite, or open bite
- Patients with sleep-disordered breathing or obstructive sleep apnea, resulting from a deficient skeletal framework of the airway
- Patients seeking aesthetic improvement, such as a stronger chin, better facial symmetry, or a more balanced profile
When jaw anatomy is at the root of the problem, surgery addresses it directly rather than working around it and simply treating the symptoms.
What does the treatment process for corrective jaw surgery involve?
The answer depends on what's driving the surgery, as surgery with an end goal of bite correction follows a rather different path than that for airway improvement.
For patients pursuing orthognathic surgery to correct a bite or jaw discrepancy, the process typically begins with orthodontic treatment. Teeth naturally compensate over time for the jaw position they're in, and aligning them within each jaw before surgery is what allows the jaws to fit together properly afterward. This phase can take anywhere from several months to over a year. Once your orthodontist determines you're ready, we move into surgical planning. Dr. Miller uses a virtual surgical plan to map out the precise movements of the jaw and presents this to you before anything is scheduled, so you understand exactly what will be done and what to expect. After surgery, a brief period of orthodontic refinement fine-tunes the final bite, followed by retention. From start to finish, the full process typically spans two to four years.
For patients pursuing jaw surgery primarily for sleep-disordered breathing or obstructive sleep apnea, the process looks different. It begins with a formal sleep study if one hasn't been done already, which establishes the diagnosis and severity of the airway obstruction. From there, evaluation focuses on whether jaw anatomy is a meaningful contributor, which requires a thorough review of your imaging and airway structure. Orthodontic preparation may or may not be part of the plan depending on your bite. Surgical planning, the procedure itself, and recovery follow the same general sequence as the bite-correction track; the difference is in how you get to the operating table.
In both cases, surgery is performed at The Brooklyn Hospital Center. Pre-surgical testing is completed in the weeks beforehand. The procedure itself takes several hours, and most patients are discharged the same day, though more complex cases may involve an overnight stay.
What is recovery like after jaw surgery?
Recovery after jaw surgery is significant but manageable, and most patients find it more tolerable than they anticipated going in. Many patients are surprised to discover that pain is fairly minimal — typically described as pressure rather than true pain — and it is usually well-controlled with scheduled ibuprofen and acetaminophen. Opioids are reserved for breakthrough pain and rarely needed beyond the first few days.
Swelling is the most visible early change and peaks around 48 to 72 hours after surgery. The degree of swelling varies depending on the length and complexity of surgery, but it can be profound and linger for some time. Most will resolve within the first month, but subtle fullness of the facial soft tissues can remain for up to a year. Bruising and limited mouth opening are also common in the first few weeks and improve steadily over the following months. Some patients experience nausea in the first couple of days, but this is managed with anti-nausea medications and is typically short-lived.
Most patients take two to four weeks off work or school, though return to full everyday activities averages around five weeks, and strenuous physical activity takes longer. Full bony healing and complete resolution of swelling take several months.
What can I eat after jaw surgery?
A no-chew diet is necessary for at least the first four weeks. In rare cases where the jaws are wired or banded closed, a full liquid diet must be taken through a syringe or gap between the teeth. As jaw mobility returns, soft and blended foods are introduced before a gradual return to a normal diet, typically over six to eight weeks. Some difficulty with hard foods can persist for a few months.
Because the dietary transition takes time, nutritional planning before surgery is worth taking seriously. Adequate nutritional intake is essential for healing, but even so, many patients will struggle with this. Weight loss on the order of 10 pounds in the first month is common, though most patients will return to their preoperative weight by about four months. We often recommend meal replacement shakes as a foundation (brands like Huel, Ka'Chava, or Soylent are popular choices), as they are nutritionally complete, calorie-dense, and easy to take without chewing.
What are the risks and side effects of jaw surgery?
Like any major surgical procedure, orthognathic surgery carries risks that every patient should understand before moving forward. Most fall into one of two categories: expected side effects that are a normal part of the process, and less common complications that occur in a smaller subset of patients.
Swelling, bruising, and temporary numbness are expected after surgery and not signs that something has gone wrong. Numbness of the lower lip and chin is particularly common after lower jaw surgery, affecting the majority of patients in the early weeks. For most patients sensation returns gradually, though recovery is more reliable in younger patients. By two years, roughly 14% still notice some change in sensation. Permanent numbness occurs in a smaller subset and is best understood as an inherent tradeoff of the procedure rather than a complication in the traditional sense.
Relapse, or a partial shift of the jaw back toward its original position during healing, occurs to some degree in a minority of patients. Most cases are minor and do not affect the functional or aesthetic result, and are treatable with post-surgical orthodontic refinement. Significant relapse requiring revision is less common but possible.
TMJ symptoms are worth understanding going in. For many patients, correcting the skeletal relationship improves jaw joint loading and reduces pain. For a few others, TMJ symptoms can emerge or worsen after surgery. This is not fully predictable, and patients with pre-existing TMJ issues should discuss this specifically before proceeding.
Less common complications include infection and issues related to the titanium plates and screws used to stabilize the jaw during healing. These are permanent in most cases and cause no problems; occasionally they require removal.
Of course, every patient is different, and the specific risks to your case are thoroughly reviewed at your consultation.