In short
Corrective jaw surgery, or orthognathic surgery, repositions the upper jaw, lower jaw or both when a bite problem is caused by jaw position rather than tooth position. It is planned jointly with an orthodontist and typically involves braces before and after surgery, over roughly eighteen to twenty-four months.
The short version
- Braces move teeth; they cannot move jaws. Where the jaw position is the problem, surgery is the part that fixes it.
- The usual sequence is braces, then surgery, then braces — commonly eighteen to twenty-four months in total.
- Most cases are functional rather than cosmetic: chewing, breathing, speech and long-term joint health.
Some bite problems cannot be solved by moving teeth, because the teeth are not what is out of position. The jaws are.
Orthognathic surgery addresses that directly. It is a significant undertaking, planned over a long period, and it is worth understanding properly — including the cases where it is not the right answer.
The distinction that matters
Orthodontics moves teeth within the bone that holds them. It does this very effectively, and for crowding, spacing and mild bite discrepancies it is entirely sufficient.
What it cannot do is change where the jawbones sit relative to each other and to the skull. If the lower jaw is set back by a centimetre, braces can tilt the teeth to disguise it, but the jaw remains where it was — and tilted teeth are less stable, often relapse, and can strain the supporting bone.
This is why patients sometimes complete years of orthodontic treatment, achieve straight teeth, and still find that chewing does not work properly. The teeth were never the problem.
Who it is for
Lower jaw set back — the commonest presentation, producing a receding chin and front teeth that stick out because they have compensated.
Lower jaw protruding, where the lower teeth sit in front of the upper ones.
Open bite, where the back teeth touch but the front teeth never meet, making biting into food impossible.
Facial asymmetry, where the jaw deviates to one side, often from asymmetric growth.
Gummy smile caused by vertical excess of the upper jaw rather than by gum tissue, which gum surgery will not correct.
Obstructive sleep apnoea in selected patients, where advancing both jaws enlarges the airway.
Timing matters: surgery is normally carried out after facial growth is complete, around seventeen to eighteen in girls and eighteen to twenty-one in boys. There is no upper age limit.
The sequence
Assessment and planning. Joint consultation with the orthodontist and surgeon, records, photographs, a CT scan and digital planning. You should see a simulation of the proposed result and understand what is realistic before committing.
Pre-surgical orthodontics, typically twelve to eighteen months. This is the counterintuitive part: braces first remove the compensations the teeth have made, which usually makes the bite look temporarily worse. Patients need warning about this, because the stage where things visibly deteriorate lasts a year.
Surgery. Under general anaesthesia, two to four hours depending on whether one or both jaws are moved. The upper jaw is repositioned through a Le Fort I osteotomy, the lower through a bilateral sagittal split, and the chin can be adjusted with a genioplasty. Plates and screws hold the new position.
Post-surgical orthodontics, around six months, to settle the bite precisely, followed by retainers.
Recovery, realistically
Two to four days in hospital. Swelling is considerable and peaks around day three — patients are consistently surprised by how much, and it is worth being prepared.
Jaws are usually guided by elastics rather than wired shut. Liquid then soft diet for around six weeks, which means planning nutrition rather than improvising it. Numbness of the lower lip and chin is expected after lower jaw surgery and resolves over weeks to months, occasionally with a small permanent area.
Most patients return to work or study at three to four weeks. Exercise resumes gradually; contact sports wait around three months.
Risks worth knowing
This is major elective surgery and the risks should be stated plainly rather than buried.
Altered sensation of the lower lip and chin after lower jaw surgery is expected rather than a complication, because the nerve runs through the bone that is being cut. It recovers over weeks to months in most patients; a small permanent area of reduced sensation is not unusual and does not affect movement or appearance.
Relapse, where the jaw drifts partly back toward its original position, is uncommon with modern fixation but more likely in large movements and in open bite cases.
Jaw joint symptoms can improve, stay the same, or occasionally worsen. Patients with existing TMJ problems need that assessed before planning.
Also: infection, plate problems requiring removal, unfavourable splits of the bone during surgery, and the ordinary risks of general anaesthesia. None of these are common, and all of them should be discussed by name before consent.
What it costs, and why it varies
Orthognathic treatment is not one fee. It is orthodontic treatment before and after, surgical fees, hospital and anaesthesia charges, imaging and planning, and follow-up — spread across roughly two years.
What moves the total most is whether one jaw or both are operated on, whether a genioplasty is included, the length of orthodontic treatment required, and the hospital setting. A single-jaw case in a patient who needs twelve months of braces is a different proposition from a two-jaw case with eighteen months either side.
Because the indication is usually functional rather than cosmetic, insurance frequently contributes, often substantially. This varies by policy and requires pre-authorisation, so ask for the procedure codes and submit before treatment rather than after. Patients who assume they will not be covered and never ask are the ones who end up paying unnecessarily.
Deciding
This is elective surgery with a long timeline, and nobody should be rushed into it. Reasonable questions: what happens if I do nothing, and does the problem progress? Is there an orthodontic-only compromise, and what are its limits? How many of these has the surgeon performed? What is the total cost including orthodontics, hospital and follow-up? What does the digital plan predict, and how reliable is that prediction?
Some patients, having heard all of it, choose orthodontic camouflage instead and are content. That is a legitimate decision, and a surgeon who cannot describe the non-surgical option fairly is not giving you enough to decide with.
Corrective jaw surgery is assessed and planned at Elegancia by Dr. Tasveer Fatima, MDS (Oral & Maxillofacial Surgery), working with the patient’s orthodontist. Consultations are available at Khurram Nagar and Bakshi Ka Talab.
Frequently asked questions
If your teeth are crooked but your jaws meet reasonably, braces alone are usually sufficient. If your lower jaw is noticeably set back or protruding, your front teeth do not meet at all when the back teeth touch, your face is asymmetrical, or an orthodontist has said the correction is beyond what braces can achieve, the jaw position is likely the issue. A combined orthodontic and surgical assessment settles it.
Usually not. Most cases are done for function — chewing efficiency, bite stability, speech, jaw joint strain and sometimes obstructive sleep apnoea. Facial appearance changes as a consequence, often substantially, but the indication is normally functional. This distinction also matters for insurance.
Hospital stay is typically two to four days. Significant swelling settles over three to four weeks, with residual swelling resolving over several months. Soft diet for about six weeks. Most people return to work or study at three to four weeks. Full bone healing and final orthodontic refinement extend over six to twelve months.
Generally no. The great majority of orthognathic surgery is performed through incisions inside the mouth, leaving no external scar. Occasional approaches require small external incisions placed in natural skin creases.
Worried about any of this?
An article cannot examine your mouth. Call and describe the problem — we will tell you honestly whether you need to be seen urgently or whether it can wait.