Jaw Surgery for Facial Structure Problems, Explained by Our Dentists With Steps and Costs

Have you ever wondered what can be done about a protruding, long, receding or short chin, protruding lips or an uneven face that makes everyday life harder, from chewing and swallowing to how you look and how confident you feel? How can the face be brought back into balance? The answer is jaw surgery. So what problems can jaw surgery fix, how is it done, are there side effects, and how much does it cost? Our dental team answers these questions below, along with what you should know before treatment.

What Is Jaw Surgery?

Jaw surgery is an operation that repositions the upper and lower jawbones into a suitable position. It improves the appearance of the face and lets the jaws work properly.

Jaw Surgery Combined With Braces (Orthognathic Surgery)

In most cases, jaw surgery is done together with braces, because a misshapen jaw usually goes hand in hand with misaligned teeth, which can lead to further problems. Treatment therefore combines braces with jaw surgery. Jaw surgery can involve the upper jaw or the lower jaw, as described below.

Jaw surgery can be done in two ways:

• Surgery first, braces after. This approach is becoming more common. Instead of 1–2 years of braces to prepare for surgery, the surgery is done first and braces follow. It saves time, but the orthodontic and surgical teams need to select suitable cases carefully.
• Braces first, then surgery. This is the traditional approach, and its results are highly predictable. Braces correct the position of the teeth first, and the jaw surgery follows.

Upper jaw surgery corrects an upper jaw that sits too far forward or too far back, causing bite problems or a smile that shows too much or too little gum. The surgeon cuts the bone above the teeth so the whole upper jaw can move into the right position, then fixes it with bone plates and screws.

Lower jaw surgery corrects a lower jaw that sits too far back or too far forward. The surgeon moves the lower jawbone by cutting behind the molars and along the length of the jawbone, places the jaw in the right position and holds it with screws until it has healed.

Patients who want to learn about the braces stage first can read: First Braces: How to Prepare and How Much It Costs

Problems Jaw Surgery Can Correct

Jaw surgery is usually done to correct abnormalities of the facial and jaw bones, which often lead to problems such as:

Jaw Surgery to Correct Facial Imbalance or Asymmetry

When the face is out of proportion, for example with full or protruding lips, a protruding chin, or a chin or face that is off-center, it can be corrected with braces and jaw surgery. The jawbones are moved into a better position, which also improves the shape of the face.

Jaw Surgery to Improve Chewing

When the upper or lower jaw is out of position, it can cause problems with the jaw joint, such as inflammation of the joint. Left untreated for a long time, the joint can degenerate.

It can also affect the gums and teeth in other ways, such as gum inflammation, which in turn causes problems with chewing. These problems can go on to affect other systems in the body and daily life, so the cause has to be corrected at its source with jaw surgery.

After jaw surgery, other dental issues can be treated, such as scaling, wisdom tooth removal, root canal treatment or braces, whether metal braces, Damon braces or clear aligners, depending on what is convenient and suitable.

Jaw Surgery to Reduce Tooth Wear and Fractures

Some people with an uneven face and misaligned jaws have bite problems. The teeth may meet on one side but not the other, so when they chew or clench, the teeth on the side that meets take more force and can wear down or crack. Jaw surgery corrects this and reduces tooth wear and fractures.

Jaw Surgery to Correct Speech and Swallowing Problems

A misshapen jaw that causes an uneven face, protruding lips or a protruding chin can be severe enough that the lips cannot close fully, even while eating. This can make swallowing difficult or speech unclear, and jaw surgery can correct it.

Jaw Surgery to Relieve Sleep Apnea or Snoring

Jaw problems can also affect sleep, causing snoring or pauses in breathing during sleep (sleep apnea), because the jaws sit close to part of the airway. In some cases, sleep apnea or snoring can be relieved with jaw surgery. The surgery moves both the upper and lower jaws forward, which keeps the surrounding muscles from blocking the airway and opens up more space for breathing.

Is Jaw Surgery Dangerous?

Jaw surgery is considered a safe procedure when it is performed by a dentist who specializes in oral and maxillofacial surgery, often called a maxillofacial surgeon. Surgery is done only once a patient has finished growing, to make sure the bones will not shift or grow further. Women can have it from age 18 and men from age 20.

Possible Side Effects of Jaw Surgery

Jaw surgery corrects bite problems caused by a mismatch between the upper and lower jawbones. These problems cannot be fixed with orthodontic treatment alone and need surgery as well. The operation is done under general anesthesia, and most incisions are inside the mouth. The surgeon cuts the jawbones and repositions them according to the treatment plan, using the bite as the main guide, then fixes them with small titanium plates and screws. Possible side effects include:

• Infection, which is uncommon after jaw surgery but can happen
• Nerve damage, causing numbness of the chin and lips. It may be short-term or long-term. In many patients it improves over about 3–12 months
• Relapse of the bone, so the jaw or bite drifts back toward its original position
• Heavy bleeding from other complications

How to Prepare for Jaw Surgery

Patients should prepare well before jaw surgery:

• Learn about jaw surgery beforehand. Before the operation, you will talk with the surgeon about the expected results, as well as the risks and possible complications
• Tell the surgeon about any medical conditions, the medications you take and any drug or substance allergies
• Do not eat or drink for at least 8 hours before surgery
• Stop drinking alcohol and smoking 1 week before surgery and for 1 month after, to prevent the blood vessels from constricting
• Avoid cosmetic facial surgery for at least 6 months before jaw surgery
• Follow your surgeon’s advice on when to stop vitamins and supplements before surgery
• Have a physical exam before surgery to check that your body is ready, for example blood pressure, a general health check, blood tests and a heart rate check
• Brush your teeth thoroughly before jaw surgery to avoid infection in the mouth

Jaw Surgery Procedure

Jaw surgery is done through the mouth, so there are no scars on the face, chin or around the lips. The exception is when small incisions outside the mouth are needed for an additional procedure, such as cheekbone reduction. The steps are:

• The surgical team scans the patient’s jaws with an intraoral scanner to plan the surgery
• Before surgery, the surgeon goes through the treatment plan for each case, including how the jaws will be moved and which areas will be corrected. Patients see a simulation of the expected result before the operation
• On the day of surgery, the surgeon cuts and repositions the bone inside the mouth to match the treatment plan
• Once the bone is in the planned position, it is fixed with small bone plates and screws, which can integrate with the bone over time
• If the patient also wants jaw angle or chin surgery, the team can do it in the same operation. This should be discussed before surgery so the result suits the face

Jaw Surgery Prices

Aftercare Following Jaw Surgery

After jaw surgery, follow these instructions strictly to help the wounds in the mouth and the facial swelling heal faster:

• Apply cold compresses in the first days after surgery, then switch to warm compresses when your surgeon advises, to reduce swelling and bruising
• Take your medicine exactly as prescribed and finish the full course. Do not stop, increase or reduce the dose. The only exception is an allergic reaction: in that case, stop the medicine and contact your surgical team right away
• Sleep with your head raised at about 30 degrees for around 2 weeks to help the swelling go down faster
• Try to bite into the position set by the surgical splint
• Clean your mouth and wounds gently and carefully with a small toothbrush to prevent infection
• Avoid strenuous exercise, because it can make you tense the muscles around the mouth
• Do not smoke

What Can You Eat After Jaw Surgery?

Jaw surgery is done inside the mouth, so patients cannot eat normally afterward, but they can have liquid food. Avoid chewing for at least about 2 months, because the jawbones have not yet fused, although the jaw can still move. Keep to liquid or soft foods as your dentist advises, clean your mouth thoroughly and correctly to prevent infection, and avoid alcohol for at least 1 month.

Jaw Surgery Reviews

For people whose jaw sits further forward or further back than normal, jaw surgery combined with braces can bring the jaw into position. Because jaw surgery changes the structure of the face, it brings the face into better balance. It also corrects chewing problems and unclear speech, which can give patients more confidence and a better presence.

How Much Does Jaw Surgery Cost?

The cost of jaw surgery depends on how severe each person’s problem is. Prices start from 145,000 THB, which includes the hospital stay.