Double Jaw Surgery - Procedure, Recovery, Risks & Cost

What is Double Jaw Surgery?

Jaw surgery, or orthognathic surgery, corrects jaw problems and related conditions.

Most people undergo jaw surgery to treat conditions that can’t be treated with orthodontics alone. Many people wear braces before jaw surgery and afterwards during recovery. 

Oral and maxillofacial surgeons perform jaw surgeries. They may also collaborate with an orthodontist during the course of the treatment. 

If someone undergoes surgery on the upper and lower jaws at the same time, the surgery is called bimaxillary osteotomy, or double jaw surgery.

Who Needs Double Jaw Surgery?

Someone may require jaw surgery for several reasons. You may undergo corrective jaw surgery to:

• Treat jaw or facial injuries
• Correct problems with function (e.g., speech and chewing)
• Correct jaw closure issues 
• Correct problems with your bite, such as when the molars touch but the front teeth don’t (open bite)
• Improve the ability to close the lips fully
• Repair birth defects (e.g., cleft lip or palate) 
• Help treat obstructive sleep apnea
• Help treat temporomandibular joint (TMJ) disorder or other jaw conditions
• Correct facial imbalances, such as underbites, crossbites, overbites, or small chins
• Correct receding or protruding upper jaws
• Change how much of the teeth show
• Treat people who have reduced growth in the middle of their face

Most people undergo jaw surgery after their skeletal growth stops, which is around 14 to 16 years of age for females and 17 to 21 for males. 

Double Jaw Surgery: What to Expect

Below is the timeline for what to expect before, during, and after double jaw surgery:

What to expect months to years before surgery

Most people need to wear braces for 12 to 18 months before surgery. Wearing braces will help align and level out your teeth. 

Getting temporary orthodontic anchorage devices can help move your teeth quicker and reduce how long you need to wear braces. If your teeth don’t fit together properly, you may need to get crowns or have your teeth reshaped before surgery.

An oral and maxillofacial surgeon will work with your orthodontist. They will often take X-rays, models, and pictures of your teeth to help formulate your surgery plan.

What to expect immediately before surgery

Before jaw surgery, a medical professional will administer general anesthesia to you. This means you won’t be awake or feel anything during the procedure. Most jaw surgeries take place in a hospital. 

What happens during the procedure

During double jaw surgery, a surgeon will work on both the upper jaw and lower jaw.

Jaw surgery is often done inside the mouth so there aren’t scars on the outside of your jaw, chin, or mouth. A surgeon may need to make minor cuts outside the mouth in some cases.

During the procedure, your surgeon cuts into the jawbones and then physically moves them.

After moving the jaw bones into the new position, the surgeon uses small screws, wires, rubber bands, and bone plates to secure the bones into their new position. Over time, these screws become part of the bone structure.

Some people may also have extra pieces of bone added to their jaws. This extra bone is often taken from the hip, rib, or leg and secured with screws and plates. The surgeon may also remove or shave away excess bone if you have an open bite.

During jaw surgery, your surgeon may use virtual surgical planning, which allows for a computer generated surgical plan and customized instruments. 

Jaw Surgery Recovery and Aftercare

Many people spend 2 to 4 days in the hospital after their surgery. It usually takes around 6 weeks for your jaw to heal after surgery. But the full healing process or recovery time may take as long as 12 weeks.

In the days to weeks following double jaw surgery you will likely experience:

• Pain and swelling in or around your jaws
• Numbness in the jaw, lips, or cheeks
• Stiffness in your jaws
• Nasal blockage and bloody discharge
• Dry lips or mouth

Depending on the severity of your surgery, it might also take some time to adjust to how your face looks.

Your doctor may advise you to stick to a soft food or liquid diet while you’re healing. If you do, you may need to take nutritional supplements. 

Your surgeon or orthodontist will give you special instructions on how to take care of yourself while you recover. These instructions often include:

• What you can and cannot eat 
• How to keep your mouth and teeth clean
• What pain medication you can take to control pain and how often to take them
• When it’s safe to start doing strenuous activities again
• When you can go back to school or work
• When you can safely blow your nose again

Your doctor will also tell you to:

• Get enough sleep
• Stay hydrated
• Avoid alcohol or tobacco products

Around 6 weeks after jaw surgery, your orthodontist will place braces on your teeth to keep them in alignment. You might need to wear braces for 6 to 9 months.

Once your braces are removed, you will need to wear retainers indefinitely to keep your teeth in their new position. In total, it can take several years to fully fix your jaw or teeth alignment problems.

Benefits and Risks of Double Jaw Surgery

As with any surgery, there are potential benefits and risks associated with jaw surgery.

Benefits

If your surgery and recovery go well, you should:

• Be able to chew food, sleep, and breathe more easily, which increases quality of life 
• Notice speech improvements 
• Notice improvements in facial appearance
• Have reduced jaw and/or facial pain 

Risks

Jaw surgery is typically safe if done by an experienced surgeon. With all surgeries, there are risks and potential complications, such as:

• Infection of the surgical site
• Nerve damage
• Jaw muscle damage
• Blood loss
• Jaw injuries, such as fractures
• Tooth damage
• Jaw joint pain
• Issues with how the teeth come together 
• Need to undergo root canal therapy
• Loss of a portion or portions of the jaw
• Permanent lip or cheek numbness
• Relapse 
• Need for additional surgeries in the future

How Much Does Double Jaw Surgery Cost?

The cost of double jaw surgery depends largely on the type or extent of the surgery. By some estimates, it often costs between $20,000 to $40,000. This price usually includes consultations before surgery, the cost of the actual surgery, and follow-up care.

If you have a medical need for jaw surgery, your health insurance may partially or totally cover it.

Alternative Treatment Options

In some cases, certain treatments or devices may eliminate the need for jaw surgery.

Alternative treatment options for jaw and teeth alignment problems include:

• Braces, clear aligners, or retainers for uneven teeth or bite problems
• Continuous positive airway pressure (CPAP) therapy, adaptive servo-ventilation (ASV), or supplemental oxygen therapy for sleep apnea
• Nightguards, non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, ice packs, and behavioral therapy for TMJ disorders