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Orthognathic Surgery
Orthognathic surgery corrects midface and jaw deformities specifically related to occlusion, or the way the teeth come together. The reason for this surgery is usually related to disproportionate growth, either in the maxilla (the midface bone containing the teeth) or the mandible (the lower jaw).
Various procedures can be performed in the area of orthognathic surgery. For example, it may be necessary to move the maxilla (the top jaw) forward and down, and even to widen it if there is a growth deficiency in the midface. Also, the midface can be intruded vertically (shortened) if there is an overgrowth causing a smile that shows too much gingiva (gum tissue) and difficulty getting the lips together around the teeth.
Surgery in the mandible can involve advancement operations if the lower jaw has not grown enough, or set-back operations if it has grown too much. Set-back operations correct an underbite, a condition that occurs when the front teeth on the top are behind the front teeth on the bottom.
The most common operation to advance or set back the jaw is called a saggital split osteotomy, developed by a German surgeon named Dr. Hugo Obwegeser. The saggital split is made to protect the nerve that provides sensation to the lower lip running through the middle of the jaw. This type of surgery also allows for the placement of bone screws or plates, and the patient, therefore, does not have to have his or her jaws wired together at the end of the procedure. These screws are inserted into the jaw by making a small ¼ inch incision on the side of the cheek to allow the screw driver to pass through. The scars are usually very minor, like the scar of having a mole removed.
However, jaw surgery to correct malocclusion (abnormal bite) may not be enough to fully correct the facial-skeletal proportions and lip competency (the ability to bring the lips together at rest without straining). Additional procedures might include chin surgery, nasal surgery, cheek bone augmentation (increase in size), liposuction (fat removal), and bone grafting. The surgery can take 1-1/2 to 10 hours depending on the difficulty of the operation and if additional procedures are done at the same time. The orthognathic operation is performed in the hospital or in an outpatient surgery center, depending on the extent of the surgery and the overall needs of the patient. The surgery is done using a general anesthetic with an endotracheal breathing tube passed through the nose, allowing the anesthesiologist to assist the patient's breathing while he or she is asleep.
Most patients do not have a great deal of pain following the procedure. Oral pain medication in liquid form is usually adequate. Most patients are dismissed within 24 hours; however, a few patients require two to three days of hospitalization.
Orthognathic surgery is usually performed in late adolescence, after the patient's growth spurt has occurred, or in adulthood, since a child's future growth can be unpredictable. It should be noted that this type of surgery is performed to correct functional growth deformities. It is not a cosmetic procedure and is typically covered by major medical insurance.
Orthognathic surgery is usually performed in conjunction with orthodontic therapy. The purpose of the orthodontic therapy is to level and align the teeth so that once the surgeon moves the jaw bones, the teeth then fit together. Usually, in this pre-surgical phase of orthodontics, the malocclusion (improper tooth alignment) is made worse. The surgery moves the bones so the teeth fit together. Usually a period of post-surgical orthodontics are required after the surgery.
The doctors of Park Meadows Cosmetic Surgery are highly qualified to surgically assist orthognathic patients. With their unique dual degrees in both the dental and medical professions, and with their experience and training in cosmetic surgery, Doctor Robinson has the certification, education, artistry, and compassion to give orthognathic patients the best possible surgical outcome. With our doctors' surgical skill, combined with the expertise of an orthodontist, an orthognathic patient can face the future with a new and empowering confidence.
The doctors of Park Meadows Cosmetic Surgery are highly qualified to surgically assist orthognathic patients. Combining surgical expertise of an orthodontist, can allow an orthognathic patient to face the future with a new and empowering confidence. To learn more about orthognathic surgery please call our office to schedule a personalized consultation with one of our doctors.
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