What is Upper Jaw or Maxillary Orthognathic Surgery

Upper jaw surgery, or maxillary “Orthognathic” surgery, is performed to correct mid-facial skeletal abnormalities, misaligned jaws, and dental irregularities. The upper jaw or “maxilla” is the largest bone in the mid-face. The maxilla extends from the frontal bone of the skull down to the upper teeth and also forms the lower portion of the orbit (eye socket). The maxilla contains the nasal passages and maxillary sinuses. Orthognathic upper jaw surgery, performed by oral and maxillofacial surgeons, not only improves a patient’s smile and appearance, but also their ability to chew, speak and breathe. Other benefits of upper jaw surgery may include the relief of facial pain, headaches, snoring and obstructive sleep disorders, including sleep apnea. While a patient’s appearance may be dramatically enhanced as a result of orthognathic surgery, corrective jaw surgery is performed primarily to correct functional problems.

Upper jaw surgery also called Lefort maxillary surgery involves repositioning all or part of the upper jaw. This may be performed to correct a small or recessive upper jaw in an under-bite or long upper jaw in the case of a “gummy smile.” It may also involve the vertical lengthening of the upper jaw in patients with a short lower or mid-face. These patients often show a very small amount of their teeth when smiling. Upper jaw surgery may also be used to correct an open bite. Many patients require treatment of both upper jaw and lower jaw often called “double jaw surgery”. In some cases, other facial cosmetic surgery may be done simultaneously with orthognathic jaw surgery.

Who Needs Orthognathic Upper Jaw Surgery?

People who benefit from orthognathic upper jaw surgery are those who are misaligned teeth and jaws creating an improper bite, which may be an under-bite overbite or open-bite. Jaw growth is a gradual process, and the upper and lower jaws may occasionally grow at different rates. This can cause functional problems including difficulty with chewing, speaking, breathing, sleeping and overall oral health. A severe misalignment may affect a person’s appearance and produce psychological or emotional problems.
Jaw or head injuries and birth defects may also affect jaw alignment. Orthodontic braces correct bite problems caused by tooth misalignment, and Orthognathic surgery corrects jaw misalignment.

Conditions that may Need Orthognathic Upper Jaw Surgery:

  • Difficulty chewing or biting food
  • Difficulty swallowing
  • Chronic jaw or jaw joint (TMJ) pain and headache
  • Excessive wear on the teeth
  • Under bite
  • Overbite
  • Open bite (space between the upper and lower teeth when the mouth is closed)
  • Unbalanced facial appearance from the front or side
  • Facial injury or birth defects
  • Receding upper jaw or sunken appearance of the midface
  • Protruding upper jaw
  • Long upper jaw “gummy smile”
  • Inability to make one’s lips meet without straining
  • Breathing Problems – Chronic mouth breathing and dry mouth
  • Snoring
  • Sleep apnea (breathing problems when sleeping, including snoring)
  • Speech Problems

Upper Jaw Surgery may also involve treatment of:

  • Lower Jaw (Mandible)
  • Cheekbones
  • Nasal Bones
  • Other Facial Bones

What are the Benefits of Upper Jaw Surgery?

Orthognathic surgery moves your teeth and jaws into positions that are more balanced, functional and healthy. Although the goal of orthognathic surgery is to improve your bite and function, many patients also experience enhancements to their appearance, breathing and speech. Orthognathic surgery can have a dramatic and positive effect on many aspects of your life, and it’s likely that your self-esteem and confidence will be significantly boosted.

Bite Correction and Improved Chewing – Upper Jaw Surgery often results in a dramatic change, frequently helping many to chew food more normally and eat things that they have been previously unable to eat.
Reduction in Jaw pain – This jaw pain or jaw muscle pain reduction occurs for many patients, however, there is no absolute guarantee that correction of jaw positioning will totally eliminate or reduce pain.
Improved Facial Appearance –Upper Jaw Surgery may often result in more facial balance and harmony, which will improve facial appearance, while correcting over-bites, under-bites, cross- bites and open bites.

Improved Breathing – Orthognathic upper jaw surgery is performed for facial balance and frequently improves the ability to breathe. Corrective jaw surgery often improves problems associated with sleep apnea, which can cause or be associated with other serious medical problems.

Improved Speech – Proper alignment of the jaw may aid in the development of normal speech patterns. Jaw surgery may need to be combined with speech therapy to correct some speech abnormalities.

Reduction in Treatment Time – A combined orthodontic and surgical approach can be completed in a shorter period of time since movement of the jawbone to a better anatomical position may decrease the amount of orthodontic treatment that is necessary.

The Maxillary Surgical Procedure

Upper jaw surgery is usually performed in the hospital and may require you to stay overnight. Some cases may be done as an outpatient allowing you to go home after recovering from anesthesia. The duration of orthognathic surgery varies with the type of surgery and the severity of the abnormality. Dr. Joseph will give you an idea of approximate time required for your particular surgery.

Upper Jaw Surgery (Lefort Surgery)

The maxilla extends from the frontal bone of the skull down to the upper teeth and also forms the lower portion of the orbit (eye socket). The maxilla contains the nasal passages, maxillary sinus and the nasal turbinates, which aid in humidifying the air that we breathe. In upper jaw or maxillary Lefort surgery, the jaw is separated from its base and then repositioned up, down, forward or backward. The maxilla may also be cut or divided into multiple pieces to expand constrict or reshape the jaw. Dr. Joseph will then move your facial bones according to your specific needs. Occasionally, bone is added (bone grafting) or taken away or reshaped. Tiny titanium surgical plates and screws are used to hold your jaw in the new position.