Orthognathic & Corrective Jaw Surgery

What is Orthognathic Surgery?

Orthognathic (meaning “straight jaws”) surgery is undertaken to re-position the jaws in order to achieve a better functional occlusion (bite), to improve facial profile or jaw definition, to correct facial asymmetry, or to increase the size of the airway in patients with obstructive sleep apnoea and breathing problems. It can also be used to address problems related to congenital deformities (e.g. cleft lip and palate patients), or where previous trauma has resulted in mal-position of the jaws.

While Orthognathic surgery is primarily done for functional reasons, functionally correcting the position of the facial bones often results in an improved facial appearance also. Orthognathic surgery may also be considered for cosmetic reasons primarily, and remains a powerful procedure for re-suspending the facial soft tissues, especially for older-age patients.

Orthognathic surgery is usually done in conjunction with orthodontic treatment (braces), done by a Specialist Orthodontist, who will work closely with the surgeon to align the teeth in each jaw in order to facilitate a stable and aesthetic result at the completion of treatment.

Orthognathic surgery is complex both in planning and execution, and requires a high level of training and expertise. Dr Armstrong is comprehensively trained and extensively experienced, both locally and internationally, in both conventional and virtual (3-D digitally planned) orthognathic surgery. He is the only surgeon in Northern NSW (including the Northern Rivers, North Coast and Byron Bay region) who has completed a sub-specialty facial deformity fellowship with advanced training in this particular field of surgery.

View All Maxillofacial Procedures

FAQs about Orthognathic & Corrective Jaw Surgery

What does orthognathic surgery involve?

Depending on the treatment required and your final surgical plan, Dr Armstrong will make a number of cuts through the bone of the jaw, to enable re-positioning, lengthening, shortening or re-shaping of one or both jaws. The bones are then held in place by titanium screws and plates, which are often custom-made for each patient’s unique facial shape.

The type of procedure is highly specific to a patient’s requirements, and is carefully planned following expert analysis of your facial profile and growth pattern. The planning is equally as important as the careful execution of your surgery.

The surgery is done under General Anaesthetic (fully asleep), in a hospital, and involves a minimum one-night stay after the procedure.

In most cases, all of the incisions are made inside the mouth, leaving no visible scars or signs of surgery aside from your facial profile improvement.

How is my surgery planned?

A full assessment of your facial profile, jaw characteristics, occlusion (bite pattern) and facial growth pattern is integral in assessing the need for surgery, and the type of surgery you may require. The decision-making and planning of orthognathic surgery requires a high-level understanding of all of these facets, and is a significant factor in achieving a good outcome.

Your work-up for surgery may also include clinical photographs, x-rays or 3-D CT scan, and a scan or models of the teeth. We utilise virtual surgical planning for precise surgery and a highly predictable outcome.

Usually, a provisional plan for your treatment is made before braces are placed. The final plan detailing the specific surgical movements is completed just before surgery, where all orthodontic changes achieved are taken into account. Dr Armstrong will liaise and collaborate closely with your Orthodontist throughout all aspects of your treatment, to ensure that the best possible outcome is achieved.

What other procedures can be done with Orthognathic Surgery?

Genioplasty (chin re-positioning) can be combined with Orthognathic Surgery, and can be an integral part of the overall plan. Similarly, it can be done at a later stage, if further profile change is required, or if it is uncertain as to whether it is suitable for you at the initial procedure.

Other facial procedures may be able to be combined with orthognathic surgery, but this is highly variable depending on the procedure - please discuss further with your surgeon if you do wish for this to be considered.

What else do I need to know?

Depending on the nature of the surgery required, it is possible that you may need a lengthy course of orthodontic treatment prior (sometimes 12 months or more) - however Dr Armstrong always prefers to review patients at the start of the process, to decide on the best course of action and to liaise with your orthodontist if required.

After surgery, you will usually have a period in “elastics” (special rubber bands) which help to overcome muscular forces, and stabilise the bite. Historically, teeth were “wired” together, but with plates and screws to stabilise the bones in a new position, this is no longer required.

Following surgery, a non-chew diet is mandated for a period of 6 weeks - however you will be advised regarding gradual progression back to a normal diet at the completion of this period, with transition from pureed food in the initial weeks, to minced and then softer foods through the final stages of bony healing.

Following your recovery from surgery, usually a further period of orthodontics is required to set the final position of the teeth, and to ensure stability of the final result.

In some situations you may require teeth to be removed (usually wisdom teeth and premolar teeth) as part of your overall treatment, which your surgeon and orthodontist will discuss further with you.

We do not routinely display pre- and post-operative photos on the website, for patient confidentiality reasons. However, at your consult, Dr Armstrong may be able to show you photographs of patients with similar presentations or facial skeletal patterns similar to your own, to help understand the types of facial changes which may be expected with surgery. It is important to understand however, that every patient’s facial characteristics are different, and not all surgical results are translatable or 100% predictable in every case.