What is double jaw surgery?

What is double jaw surgery?

Cleveland Clinic calls it bimaxillary osteotomy: a single procedure that realigns or reshapes both the upper and lower jaws. Moving only one jaw is a different, single jaw operation. Because the jaws, teeth and bite work together, the surgery is planned with an orthodontist, and a surgeon, usually an oral surgeon, carries it out. Cleveland Clinic's page refers to an oral surgeon and names no specific credentials.

Who needs double jaw surgery?

Cleveland Clinic lists a severe malocclusion, meaning a bad bite that orthodontics alone cannot correct, obstructive sleep apnea, where moving the jaws forward opens the airway, and jaw-size problems such as jaws that are too large or too small. The page does not give criteria for choosing between one-jaw and two-jaw surgery. That is a decision for a surgeon and orthodontist after assessment, and our guides on overbite and underbite explain the bite problems that sometimes lead here.

What happens before surgery?

Cleveland Clinic says orthodontic treatment, such as braces, may be needed for up to two years beforehand to position the teeth so that the jaws fit together after surgery. The page does not describe the planning, scans or models in detail. Our braces guides explain what orthodontic treatment involves.

How is the surgery done?

Cleveland Clinic lists the steps: cuts are made inside the mouth and in the jawbone, the jawbone is moved into its new position, bone is removed, reshaped or added as needed, screws, wire or plates hold the jaw in place, the second jaw is repeated, and stitches close the incisions in the mouth. It takes about four to six hours under general anesthesia, so you are asleep. Temporary plastic splints are often placed on the teeth afterwards. The hospital stay is about two days.

What is recovery like?

Cleveland Clinic says recovery takes about three to six months. It describes a liquid diet for the first two weeks, soft foods for the next three to six weeks, swelling and bruising of the lower face for several weeks, pain medication as recommended or prescribed, and activity limits, including sports, until the surgeon approves. Different pages give different overall timelines: a search summary of another Cleveland Clinic page mentioned about six weeks to return to daily routine and up to a year for full recovery, which we have not read in full and do not use. Your surgeon's plan comes first.

What are the risks?

Cleveland Clinic lists excessive bleeding, infection, nerve damage, bone damage, tooth damage, and temporomandibular joint (TMJ) disorders that develop or worsen. Ask the surgeon what the numbers are for your own case, since the page gives none.

Does it relate to TMJ disorders, jaw popping and locking?

Cleveland Clinic's TMJ page says temporomandibular disorders affect the jaw joints and the muscles around them, with symptoms including clicking, popping or grinding sounds, jaw stiffness or locking, and trouble opening or closing the mouth. It says TMD is treatable and rarely causes lasting problems, that nonsurgical options such as mouth guards, physical therapy and habit changes are usually tried first, and that surgery, such as arthrocentesis, arthroscopy or open-joint surgery, may be suggested if other treatments do not help. Double jaw surgery is a different operation for bite and jaw-position problems, though it can affect the joint, as the risk list says.

What about a TMJ flare-up?

Cleveland Clinic does not discuss flare-ups directly. It says habits can make TMD worse, including chewing on pens, ice or nails, poor posture, taking large bites, using teeth as tools, daytime clenching or sleeping on your stomach. Our guides on why the jaw pops, how to unlock a jaw and how long TMJ lasts cover those questions. A broken jaw is a different matter, which our guide on how to know if a jaw is broken explains.

Questions to ask your surgeon

Take these to your consultation.

• Do I need one jaw or both operated on?
• How long will I need braces before and after?
• What are my risks for numbness and TMJ problems?
• How long will I be off work and on a liquid diet?
• Can I see before-and-after cases like mine?

Frequently asked questions