Two jaw surgery

Overview

Jaw surgery, also known as orthognathic surgery, corrects jaw deformities. It can affect the top jaw (maxilla), the lower jaw (mandible), or both the upper and lower jaws (bimaxillary)

When both jaws are involved, the treatment is known as two jaw surgery or bimaxillary osteotomy. The objective is to improve your jaw's function and aesthetics. A surgeon may adjust your upper and lower jaws depending on jaw abnormalities. They may also alter their size by removing bone fragments.

 

What is two jaw surgery?

Orthognathic surgery is frequently performed on one jaw at a time. Maxillary osteotomy is a separate treatment that focuses on the top jaw, or maxilla. The lower jaw, or mandible, is the subject of mandibular osteotomy. Bimaxillary osteotomy corrects both jaws at the same time, earning it the moniker "two jaw surgery."

Operating on both jaws at the same time allows the surgeon the most freedom to alter the jaw bones and mold the face, providing the patient the best opportunity for a natural, aesthetically acceptable result. The surgeon uses this comprehensive approach to try to resolve all functional and aesthetic difficulties by reshaping, resizing, or relocating the upper and lower jaws into more ideal positions. Many daily processes, such as breathing, eating, swallowing, and speaking, rely on your facial shape and jaw location. 

Facial harmony appropriately aligns your teeth and chin, allowing them to operate in harmony with your facial muscles and jaw joints. Jaw surgery, also known as orthognathic surgery, can help address a variety of facial and dental abnormalities and functional dental concerns, as well as enhance the shape and proportions of your face attractively. Face bone contouring surgery is common in Asia, where beauty standards favor a soft, delicate facial shape over an acute and pronounced jawline. Two jaw surgery, also known as two-jaw surgery or bimaxillary osteotomy, is a successful technique for patients seeking functional and  aesthetic improvement in both the upper and lower jaws.

The link between the mid-face and lower face is improved by two jaw surgeries. Some Asian people have a retruded midface, a chin that is either 'too strong' or 'too weak,' and front teeth that flare. When these characteristics are combined, they result in a convex face profile, which some people attempt to fix surgically.

Two jaw surgery is popular with Asian patients globally because to shared characteristics of Asian anatomy and aesthetic preferences in various Asian nations. It is crucial to emphasize, however, that it is not limited to any single ethnic group.

 

Who needs two jaw surgeries?

Two jaw surgery can help with a range of functional concerns caused by incorrect jaw construction, such as:

• Malocclusion (misalignment of the upper and lower teeth) (misalignment of the upper and lower teeth)
• Underbite
• Overbite
• Bite open
• Chronic malocclusion causes headaches.
• Food swallowing, biting, or chewing difficulties
• Speech issues
• Teeth wear that is uneven
• Jaw joint discomfort (TMJ)
• Constant mouth breathing
• Inability to close the lips over the teeth, resulting in facial muscular tension
• Obstructive sleep apnea (OSA)
• A multidisciplinary partnership between a plastic surgeon and other experts (e.g., an orthodontist) generally delivers the greatest solutions for patients with functional difficulties.

However, in order to be deemed a good candidate, you must also:

• Have you tried nonsurgical treatments for your condition
• If you smoke cigarettes or cannabis, you should stop (quitting can be difficult, but a doctor can help create a plan that works for you)
• comprehend the dangers
• Have grown to skeletal maturity (14 to 18 years old.

 

Are two jaw surgeries cosmetic?

Two jaw surgery can be both useful and aesthetic, or it might only be cosmetic. Patients may pursue this surgery for cosmetic reasons such as:

• Asymmetry of the face
• Gummy grin
• The recessive jaw
• Jaw protruding
• slanted chin
• Mouth protruding
• Long chin

One of the most effective facial aesthetic procedures is orthognathic surgery. Changing the size, shape, angle, and/or alignment of the jaws can enhance face equilibrium and aesthetics, as well as self-image and confidence.

 

What are the benefits of two jaw surgeries?

To correct jaw abnormalities, two jaw surgeries are utilized. The technique might include:

• Adjust jaw misalignment

Normally, the upper jaw and teeth overlap the lower teeth somewhat. This jaw position allows you to properly eat and speak. However, if your jaws are misaligned, your upper and lower teeth may not meet properly.

The following are examples of jaw misalignment:

Deep overbite, underbite, open bite, jaws that overlap, and sideways jaws that meet at an incorrect angle (asymmetric jaws). By moving or twisting your jaws, the surgeon may be able to correct these abnormalities.

 

• Jaw size is correct.

Jaw abnormalities might occur if your jaws did not expand at the same pace. Either the lower or upper jaw may be underdeveloped or enlarged. This can happen in conjunction with a misaligned jaw. The treatment can be used to fix unequal jaws. To make your jaws more proportionate, your surgeon may move your lower jaw forward or shrink them.

 

• Face features should be balanced.

Two jaw surgery may be used to rectify facial asymmetry caused by:

• wrong jaw misalignment tiny chin and jaw size
• Gummy grin
• The surgery may fix these abnormalities, restoring face balance.
• Improve your jaw function.

Normal jaw alignment and size are required for fundamental tasks such as: biting, chewing, swallowing, speaking and breathing.

If your jaw defects make these tasks difficult, two jaw surgeries may be beneficial.

 

• Relieve facial discomfort

The operation can help relieve face discomfort caused by jaw problems, such as severe temporomandibular joint (TMJ) disorders. TMJ treatment might include two -jaw surgeries. The TMJ functions as a hinge that connects your lower jawbone to your skull. Problems with this joint can cause discomfort in the jaw, cheek, or around the ear.

It may also result in: Jaw clenching, jaw clenching and chewing difficulty due to jaw cracking or clicking.

 

• Reducing obstructive sleep apnea

Your breathing briefly pauses during sleep if you have obstructive sleep apnea (OSA). It happens when the space in your airways becomes too tight, making breathing difficult while sleeping. A form of two-jaw surgery known as maxillomandibular advancement (MMA) surgery can help. Both jaws are frequently pushed forward by around 10cm. 

Your upper and lower jawbones are pushed forward throughout the process. This makes more room in your airways, allowing you to breathe more easily while sleeping. This procedure does not always result in the effective removal of OSA. 

 

What are the side effects of two jaw surgeries?

When performed by a skilled oral and maxillofacial surgeon, frequently in combination with an orthodontist, two jaw surgery is often safe.

Surgical risks may include:

• Loss of blood: If there is vascular injury, you may bleed more than intended. Your medical staff may administer a blood transfusion as well as apply pressure, bone wax, or gauze to you.
• Infection
• Nerve damage
• A fractured jaw
• Jaw relapse to its previous place
• Bite fit issues and jaw joint discomfort
• Additional surgery is required.
• Root canal treatment is required on some teeth.
• A piece of the jaw has been lost.
• Numbness of the lips. It is typical to have immediate lip numbness. Nerve damage after surgery can sometimes result in lifelong numbness.
• Hearing alterations You may experience transient hearing problems if the operation produces swelling or muscle strain.

Following surgery, you may experience:

• Swelling and pain
• Eating disorders that can be treated with nutritional supplements or by consulting a dietitian
• A brief period of acclimating to a new face appearance

 

What is the procedure for two jaw surgery?

Before surgery, an orthodontist will usually install braces on your teeth. Braces are often worn for 12 to 18 months prior to surgery to level and align your teeth. Your orthodontist and oral and maxillofacial surgeon collaborate to create a treatment plan for you.  X-rays, photographs, and models of your teeth will be used to arrange your jaw surgery. Occasionally, the discrepancy in the way teeth fit together will need tooth contouring, crowning, or both to complete correction. 

Three-dimensional CT scanning, computer-guided treatment planning, and temporary orthodontic anchoring devices may be utilized to assist with tooth movement and shorten your time in braces. These efforts can sometimes totally remove the need for jaw surgery. Virtual surgical planning (VSP) may be utilized to advise your surgeon throughout the process to fit and fix the jaw segment location for the best possible result.

• Before to the procedure

Oral and maxillofacial surgeons do jaw surgery. Surgery is often performed under general anesthesia. The surgery is performed in a hospital and needs a two- to four-day stay.

• During the procedure 

Surgery is frequently conducted within the mouth, so no facial scars appear on the chin, jaw, or around the mouth. However, tiny incisions outside your mouth may be necessary at times. The extra bone may be added to the jaw in specific circumstances. The bone is transferred from your hip, leg, or rib and secured with plates and screws by your surgeon. In some circumstances, bone may be altered to improve fit. Two jaw surgeries are done on the upper, lower, or chin.

 

Upper jaw surgery (maxillary osteotomy) 

Upper jaw surgery may be performed to correct:

• Upper jaw that is significantly receding or protrudes
• Crossbite
• Too many or too few teeth are visible.
• Bite open
• Middle-of-the-face facial growth has been reduced (midfacial hypoplasia)

Your surgeon makes incisions in the jawbones and slides them into place. Following the completion of your jaw movement, small bone plates, screws, wires, and rubber bands may be utilized to fix the bones in their new place. These screws, which are smaller than brace brackets, gradually integrate into the bone structure. Your surgeon will cut the bone above your teeth so that the entire top jaw, including the roof of your mouth and upper teeth, may move as a single unit. The jaw and upper teeth are advanced until they are appropriately aligned with the lower teeth. This may be planned on a computer to see whether any extra work, like orthodontics, is required to assist rectify any residual fit disparity.

Excess bone forms above the molars, causing what is typically a level, even surface, to become tilted. Your surgeon will shave or remove the extra bone to correct this.

Plates and screws keep the bone in its new location after the jaw has been straightened.

 

The lower jaw (mandibular osteotomy)

A mandibular osteotomy can correct the following:

• Lower jaw retraction
• Lower jaw protrusion

The surgeon makes incisions below the teeth and down the jawbone to allow the front of the jaw to move as a single unit. The jaw can then be shifted forward or backward to its new location. As the jawbone heals, plates and screws keep it together.

 

Surgery on the chin (genioplasty)

A genioplasty can be used to fix a tiny chin (deficient chin). A tiny chin is sometimes associated with a markedly receding lower jaw.

During the same procedure, physicians may usually change the jaw and remodel the chin. The surgeon removes a section of the chin bone from the front of the jaw, pushes it forward, and fixes it in place with plates and screws.

During the treatment, your surgeon may choose to work on your upper or lower jawbones first. The order is determined by their preferences and your method.

How long will two jaw surgeries take to recover?

You will most likely spend 1 to 3 nights in the hospital following two jaw surgeries. The precise time depends on your progress. For the next 48 hours, your face will be puffy. You may be able to drink water immediately after. The next day, you might be able to eat liquid meals. Before you can go home, your surgeon will examine your jaws and request X-rays. You'll need someone to drive you home once you've been released. You should plan on taking 3 to 8 weeks off from work or school.

During this time, you are likely to encounter:

• Pain. To control the discomfort, your doctor will prescribe pain medications.
• Swelling. The swelling will go down after the first 48 hours. However, it will take many weeks to completely vanish.
• Stiffness. For the first several weeks, you won't be able to open your mouth.
• Numbness. It is common to experience temporary numbness in your jaw. This takes several months to resolve.
• Lips that are parched. During rehabilitation, it is typical to have dry, chapped lips. It is advised that you use lip balm on a regular basis.
• Nose blockage. You should expect nasal congestion and bloody discharge, but avoid blowing your nose. These adverse effects will subside in a few days.

To aid in a quick recovery, it is best to:

• For the first six weeks, consume pureed or soft meals, take your medicine, and avoid smoking.
• Stay away from alcohol.
• Maintain appropriate dental hygiene (as directed by your doctor)
• Keep hydrated, avoid vigorous exercise, and relax.
• For the first several weeks, you'll have weekly follow-up appointments.

The initial stage of recuperation typically lasts 6 weeks. It may take up to 12 weeks for your jawbones to recover completely.

 

Two jaw surgery alternatives

Your orthodontist will attempt other therapies before recommending two jaw surgeries. The best solution for you is determined by your jaw anomalies.

Among the choices are:

• Braces (with or without elastics) (with or without elastics)
• Retainers for clear aligners
• Mouth shields
• Splints for the mouth
• Relaxants for the muscles (for TMJ disorders)
• Injections of Botox (for TMJ pain)
• Continuous airway pressure machines are examples of airway pressure devices (for OSA)
• Sleep apnea machine (mouthpiece)
• Jaw muscle relaxation using behavioral therapy

 

How much do two jaw surgeries cost?

The overall cost is determined on the severity of the jaw anomalies and the length of stay in the hospital.

In most cases, health insurance will pay for the operation if it is required to treat a medical condition such as obstructive sleep apnea. You may receive partial or complete coverage. If the surgery is solely aesthetic, your insurance company may refuse to pay it. Before pursuing the treatment, consult with your physician. 

 

Conclusion

Both jaws are involved in two jaw surgeries. It is used to correct jaw abnormalities such as misalignment or unequal size. If nonsurgical therapies haven't addressed your jaw problems, you could be a suitable candidate. However, like with any surgery, it may result in consequences such as numbness or hearing loss. Your orthodontist can advise you on whether the treatment is appropriate for you.