Orthognathic Surgery

What is Orthognathic Surgery?

Orthognathic surgery is surgery to reposition the upper jaw (LeFort 1), the lower jaw (bilateral sagittal split osteotomy), or the chin (genioplasty).

Who Needs Orthognathic Surgery?

Patients who need orthognathic surgery usually have one of the following problems:

  1. A small upper jaw, with or without a large lower jaw, with upper teeth that are significantly behind the lower teeth (negative underjet)

  2. A small lower jaw, with lower teeth that are significantly behind the upper teeth (positive underjet)

  3. Front teeth that do not touch (anterior openbite)

  4. Upper teeth that show too much when smiling (excessive tooth show)

  5. An excessively small chin (microgenia)

  6. An asymmetric or tilted jaw causing an occlusal cant

What Happens Before Orthognathic Surgery?

When preparing for orthognathic surgery, most patients will need to undergo orthodontics (“braces”) for a period of time. Once the surgeon and the orthodontist feel that the teeth are in the correct position, surgery can be done.

How is Orthognathic Surgery Performed?

There are several procedures that fall under the category of orthognathic surgery:

LeFort 1   LeFort 1

  1. LeFort 1: this operation moves the upper jaw in any direction. All incisions are inside the mouth


  2. Bilateral sagittal splint osteotomy (BSSO): this operation moves the lower jaw in any direction. All incisions are inside the mouth, except for a very small 3mm incision on each cheek.

  3. Genioplasty: this operation moves the chin without repositioning the jaw itself. All incisions are inside the mouth

Two or three of these operations may be combined.

What Can I Expect After Orthognathic Surgery?

Most patients spend one or two nights in the hospital, then go home.

The upper and lower jaws are usually numb for the first few weeks after surgery.

If undergoing a LeFort 1 and/or BSSO, the upper and lower teeth will be held together with dental elastics. For the first few weeks, patients have to be on a soft diet (the consistency of mashed potatoes, smoothies, etc). Pain is mild. There is swelling of the face.

Within two weeks, the swelling is usually much better and there is no pain.

After 6 weeks, the patient is usually allowed to start eating solids.