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 pertaining to the upper and lower teeth, as well as conditions of the same. There has been an increase in the number of people seeking orthognathic surgery in recent years. However, since it involves undergoing general anesthesia and the osteotomy (cutting) of the jawbone, many people are concerned about the potential risks and complications.
What is involved in jaw surgery?
There are a few different types of orthognathic surgery but they all involve the surgeon making cuts and repositioning parts of the upper jaw (maxilla), lower jaw (mandible), or both. The goal is to achieve better alignment of the teeth and a more balanced facial appearance. Some of the most common procedures include:
- Maxillary osteotomy – cutting and repositioning the upper jaw
- Mandibular osteotomy – cutting and repositioning the lower jaw
- Genioplasty – augmentation or reduction of the chin
- Lefort 1 – detaching the upper jaw and palate from the rest of the facial skeleton
The surgery is often performed along with orthodontic treatment (braces) to align the teeth properly around the newly positioned jaw(s). It takes place under general anesthesia, usually taking 1-4 hours depending on the exact procedures being performed. Patients typically have to stay 1-3 days in the hospital after surgery.
What are the risks and complications of jaw surgery?
Like any major surgery, there are risks associated with orthognathic surgery. Some potential risks and complications include:
- Infection
- Excessive bleeding
- Adverse reaction to anesthesia
- Nerve damage resulting in numbness or altered sensation in the face, lips, tongue, etc.
- Damage to tooth roots
- Nonunion of the bones when they do not heal together properly
- Malocclusion – improper bite alignment
- Relapse – bones shifting back towards their pre-surgery position
- Permanent facial asymmetry
- Difficulty breathing, swallowing, or speaking
- Chronic jaw joint and facial pain
These risks vary by the patient’s health profile and the specific procedures being performed. In general, the risk of complications is relatively low at around 3-4%. However, patients should be aware of the potential risks before consenting to surgery.
Is jaw surgery riskier than other common surgeries?
Orthognathic surgery does involve some specific risks related to manipulating facial bones and nerves. However, it is not necessarily considered an overall high-risk procedure compared to many other common surgeries. Here is some data comparing the risks:
| Surgery Type | Risk of Complications |
|---|---|
| Orthognathic surgery | 3-4% |
| Tonsillectomy | 5-10% |
| Gallbladder removal | 15-30% |
| Hip replacement | 3-7% |
| Cesarean section | 10-15% |
As shown, the risks associated specifically with jaw surgery are comparable or lower than those of several other common surgical procedures. Of course, risks increase for patients with certain pre-existing health conditions, but when performed by an experienced surgeon, jaw surgery is not considered a high-risk operation for most healthy individuals.
What factors affect the risks of complications from jaw surgery?
There are several patient-specific factors that can influence the likelihood of risks and complications after orthognathic surgery:
- Overall health – Patients with medical conditions like diabetes, heart disease, autoimmune disorders, etc. have higher surgical risks.
- Age – Younger, healthier patients tend to have lower risks than older patients.
- Smoking – Smoking severely impairs healing and increases infection risks.
- Drug/alcohol abuse – This can increase bleeding, healing, and infection risks.
- Malnutrition – Poor nutrition negatively impacts healing.
- Medications – Such as steroids or immuno-suppressants.
- Extent of surgery – More complex, longer procedures increase risk.
- Prior orthognathic surgery – Second operations tend to have more risks.
- Experience of surgeon – Inexperienced surgeons have higher complication rates.
- Following post-op instructions – Not following directions raises chances of problems.
Talking thoroughly with the surgeon before surgery about your unique health profile and risks can help minimize the chances of complications occurring.
How much recovery time is needed after jaw surgery?
The recovery time after orthognathic surgery varies but typically involves:
- 1-3 days hospital stay after surgery
- 1-2 weeks of liquid/soft food diet
- 2-4 weeks until normal activity can be resumed
- 6-8 weeks until exercise and harder foods can be tolerated
- 6-12 months for complete bone healing and stabilization
Swelling and bruising of the face is very common after surgery. Most people take 2-4 weeks off from work or school to recover. Pain, numbness, and decreased jaw motion may persist for several weeks up to a few months. Complete recovery can take up to a year. Following all post-op instructions carefully is crucial to smooth recovery.
Tips for optimal recovery after jaw surgery
- Rest and limit physical activity as directed
- Keep head elevated on pillows to minimize swelling
- Use ice packs on the face to reduce swelling
- Eat a liquid and soft food diet as instructed
- Take pain medications as needed
- Keep incisions clean; avoid smoking, drinking from straws
- Gently stretch jaw muscles and exercise mouth after approval from surgeon
- Attend all follow-up appointments for x-rays and check-ups
Conclusion
Orthognathic surgery involves some risks of complications like infection, nerve damage, and relapse. However, when performed by an experienced oral surgeon, on an otherwise healthy patient, jaw surgery does not carry significantly higher risks than various other common operations. The overall risk of major complications is relatively low at 3-4%. Certain patient factors like smoking or poorly controlled medical conditions can increase risks.
With proper presurgical planning and preparation, careful adherence to post-op protocols, and check-ups with the surgeon, most patients recover successfully from jaw surgery without any major permanent side effects. While a careful discussion of the benefits and risks is warranted between patient and surgeon, jaw surgery can be considered reasonably safe, despite being a complex procedure.