Jaw surgery, also known as orthognathic surgery, is a procedure to correct conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that cannot be easily treated with braces. There has been a lot of speculation and concern that jaw surgery may significantly alter the appearance of a person’s face. This article will examine whether jaw surgery leads to facial changes, the types of changes that can occur, why they happen, and how much change a person can expect after this procedure.
Does your face change after jaw surgery?
Yes, jaw surgery will lead to changes in the appearance of your face. Though the primary purpose of orthognathic surgery is to correct skeletal discrepancies to improve function, changes to the underlying bone structure will inevitably affect the overlying soft tissue and lead to alterations in facial aesthetics. The facial changes may be subtle or more noticeable depending on the magnitude of jaw movement and procedures done. Most patients see a difference in their smile, profile, and overall facial proportions after surgery.
How does jaw surgery change your face?
There are several ways that orthognathic surgery can lead to facial changes:
Altered jaw position
During jaw surgery, the maxilla (upper jaw) and/or mandible (lower jaw) are repositioned to correct misalignments. This inevitably shifts the entire lower facial skeleton, which leads to changes in facial proportions and profile.
For example, if the jaws are moved forward, this increases facial projection and makes the chin more prominent. If they are moved backwards or downwards, this can decrease facial projection and lead to a flatter, more retruded chin.
Changes in soft tissue and facial contours
As the underlying jaw bones are repositioned, the overlying soft tissues of the face (skin, muscles, fat, etc) adapt to the new skeletal foundation. This leads to changes in facial shape and contours.
For instance, the cheeks may become more or less prominent with jaw movements. The lips may change shape and tooth show. The facial profile can become more convex or concave. There are also changes to the appearance of the chin, jawline, and neck with alteration of the jaw position.
Improved facial symmetry
For people undergoing surgery to correct jaw asymmetry, orthognathic surgery can dramatically improve facial symmetry. Moving the deviated jaw into proper alignment makes the face more proportional on both sides.
| Type of Change | Details |
|---|---|
| Altered jaw position | – Changed facial projection and proportions |
| Soft tissue changes | – Cheek fullness, lip shape, facial contours adapt to new jaw position |
| Improved facial symmetry | – Corrects asymmetry from jaw deviations |
What specific facial features change after surgery?
Some of the key facial features that can change after orthognathic surgery include:
Chin
The chin can become more pronounced or retruded depending on if the jaw is moved downwards/forwards or upwards/backwards. Chin shape can also change, becoming pointier or squarer.
Jawline
Jaw surgery impacts the mandibular plane angle, which can make the jawline appear more square and well-defined or more rounded.
Nose
With significant maxillary (upper jaw) movement, the base of the nose can change position, altering the appearance of your nose. The tip may point up or down.
Lips
Lips tend to follow the movement of the jaws. Protrusive jaw movement makes lips more prominent with more tooth show. Retruded movement causes thinner lips with less show.
Cheeks
Cheek projection and fullness will change with the amount of forward or backward jaw movement. Cheeks become more or less prominent.
Facial profile
The profile view can change significantly based on jaw positioning. It may become more convex or concave.
What are the factors that determine how much your face changes?
The degree of facial change after orthognathic surgery depends on several factors:
Amount of jaw movement
The more significant the change in jaw position during surgery, the greater the effect on facial aesthetics. Small movements of just a few millimeters lead to subtle changes, while movements of 10 millimeters or greater result in very noticeable changes.
Direction of jaw movement
Forward (protrusive) movement tends to have more significant effects on facial appearance than backward (retruded) movement of the same magnitude.
Soft tissue thickness
Patients with thicker, more robust soft tissues show less dramatic changes compared to those with thinner faces. Thick soft tissues can mask underlying skeletal changes.
Facial growth pattern
Patients with vertical excess facial growth (long face) may have more significant profile changes from jaw surgery compared to those with normal or horizontal growth patterns.
Additional procedures
If additional procedures like genioplasty (chin surgery), rhinoplasty, or facial implants are done along with orthognathic surgery, this can further alter facial aesthetics.
Do the facial changes last permanently or go back to normal?
For the most part, the facial changes from orthognathic surgery are permanent. The bones heal and fuse in their new positions permanently. The overlying soft tissues also adapt and remodel around the new skeletal foundation.
However, there are a few factors that may cause some changes to partially relapse:
– Minor post-surgical skeletal changes or displacements during healing
– Settling and descend of soft tissues over time
– Facial aging over decades – face will change with age regardless
But in general, if you undergo corrective jaw surgery, you must be prepared for a “new face” that will be fairly permanent. Many of the changes are gradual over the first 12 months post-surgery as swelling resolves. But the overall facial change compared to pre-surgery will remain. Discuss expected changes thoroughly with your orthodontist and surgeon.
Can jaw surgery improve facial appearance?
While the primary aims of orthognathic surgery are functional – to improve bite alignment and jaw function, it can also have a number of benefits for facial aesthetics:
Enhanced facial proportions and balance
Correcting skeletal discrepancies can bring your jaws into better proportion with the rest of the face. Your facial profile is improved. Overall facial proportions become more harmonious.
Straighter smile
The teeth are better aligned with straight upper and lower arches after presurgical orthodontics and jaw correction. This gives a more attractive smile.
Correction of facial asymmetry
Jaw surgery greatly improves facial symmetry in cases with significant asymmetry from jaw deviations. The face appears more balanced and proportional.
Smoother facial profile
Protruding or retruded chins can be augmented with surgery to create a nicer facial profile. A more proportionate chin, jawline and neck profile are possible.
Better facial contours
For certain patients, changes in the underlying bone can lead to more attractive cheekbones, a well-defined jawline, and overall improved facial contours.
So while an aesthetic enhancement is not the primary goal, small improvements in facial appearance are possible with orthognathic surgery in the right patient. But the facial changes should be discussed in-depth before proceeding.
Can I see what my face will look like after surgery?
Visualizing the expected facial changes from jaw surgery beforehand is important. There are a few ways your orthodontist or surgeon may be able to show you an approximation of the anticipated changes:
Computer imaging
Using digital photographs and planning software, it is possible to create projected images showing surgical simulations and predictions of the facial changes. This can provide an idea of change in your smile, lips, cheeks, chin and overall profile.
Clinical photos of actual patients
Looking at before-and-after photos of actual patients who have undergone similar surgical plans can be useful. However, each person’s results will be individualized.
Morphing apps
Your provider may use phone apps that will take your image and thendigitally morph your face based on expected surgical movements. This morphing effect simulates possible changes.
Model surgery
Surgical predictions can be done on stone models of your arches. The models are sawed and repositioned to simulate planned movements. You can then visually inspect the anticipated dental and facial changes.
While not exact, these modalities offer some ability to preview anticipated surgical changes. Thorough discussion with your orthodontist and surgeon is key.
How can I prepare for and adjust to the facial changes?
Adjusting to facial changes after jaw surgery takes time. Here are some tips:
Discuss expected changes before surgery
Have in-depth discussions with your providers about the likely facial alterations so you know what to expect. Ask to see morphs, images or models if possible.
Focus on functional improvements
Remember that the purpose of surgery is to improve function moreso than cosmetics. Focus on these functional gains like improved breathing and bite.
Wait for swelling to subside
Your face will be very swollen early on. Wait at least 6 months for it to fully subside before judging the esthetic changes.
Give it time
It takes most patients one full year to mentally adjust and accept the changes to their appearance.
Discuss concerns with your treatment team
Bring up any difficulties or dissatisfactions you have with the changes to identify solutions or ways to cope.
Consider cosmetic procedures
If desired, adjunctive procedures like chin or cheek implants could fine tune results after you have healed from orthognathic surgery.
Conclusion
Orthognathic surgery involves complex movements of the jaws to improve function which inevitably leads to alterations in facial aesthetics. The amount of change depends on the degree of jaw movement, direction, soft tissue thickness, and other factors. While the primary goals are functional, small enhancements to facial appearance are possible if properly planned. Being prepared for the anticipated facial changes and allowing time to adjust to your new appearance are important considerations for any jaw surgery patient.
