This type of treatment can correct your occlusion (bite) and change your facial profile. In some cases treatment is planned to improve your bite, with minimal change to your facial appearance, whilst in other cases, there will be more noticeable change to your facial appearance (for example if you have a prominent lower jaw, or a small setback lower jaw).
The patients are healthy and the risks related to the general anaesthesia are minimal. The anaesthetist is consulted before surgery and all the examinations are performed after the procedure.
All the scars are inside the mouth.
Patients usually do not report any pain after the operation, but there is generally always a feeling of discomfort due to the oedema (swelling of the face), which recedes within a few days and disappears completely within a couple of weeks.
Swelling may be surprisingly big, and mayget worse over the first 48 hours. It is treated by applying ice cold compresses to the face and with appropriate medication.
The jaws, once they have been moved, are held in their new position with titanium plates and screws. It is therefore possible to talk and eat immediately.
However, a number of precautions should be taken during the postoperative period:
– The jaw bone will be held in place using elastic bands, which will need to stay in place for two weeks.
– The diet should be entirely liquid throughout the immobilisation period (15 days), then pureed for the next 15 days, then softened for the following 15 days, with a return to a normal diet 6 weeks after the operation.
– Strict oral hygiene is essential to prevent the risk of infection and should be begun immediately after the procedure. All of the
products needed for this purpose will be prescribed.
AFTER 6 WEEkS TO 3 MONTHS
Only individual sports without the risk of falls can be undertaken 6 weeks after surgery, and after 3 months for all other sports.
BETWEEN 2 AND 4 WEEkS LATEr
Depending on the type of procedure, patients can usually return to school or work between the 2nd and 6th week after the operation.
In some cases there may be an alternative treatment. You will need to ask the team, if this is possible in your case. The team will explain the advantages and disadvantages of all options.
Treatment is carried out over a period of 2 1 /2 -3 years, starting with orthodontic treatment to reposition your teeth with fixed appliances (traintrack braces). Approximately two thirds of the way through treatment you will be ready for the jaw surgery. Following the surgery, patients generally continue with the orthodontic treatment with fixed appliances for 6-9 months. When the fixed appliances are removed you will be provided with removable retainers which will help maintain your teeth in the new position. Some patients will also require a retainer fixed to their teeth. The orthodontist will advise you how much to wear the retainers. In most cases for the first year you will start wearing your retainers all the time (day and night) and will then be advised to gradually reduce the amount you wear your retainers. After a year of retainer wear, you will be advised to wear the retainers a few nights a week indefinitely. 3 Your progress will be reviewed regularly for five years after your surgery.
Jaw surgery may involve surgery to your upper jaw (maxilla) or the lower jaw (mandible) or a combination of both depending on your concerns and individual assessment by the team. The surgery is carried out from inside your mouth so there are no visible scars on your face. During jaw surgery your jaws are repositioned and held in their new position by small screws and plates beneath the gum, which are generally left there indefinitely. You will not usually have your jaws wired together. However, you will be required to wear orthodontic elastics, whilst your bite settles following the surgery. Risks associated with jaw surgery include Lip numbness: This is normal, immediately after the surgery. The upper lip recovers quickly. However the lower lip is much more variable and may take time to recover. Some patients report areas of permanent numbness which does not affect the appearance of the lip or its function. Patients reporting areas of permanent altered sensation find that this is something they get used to. Infection of the plates beneath the gum: In a small number of cases plates may become infected. If this is the case they are removed. The chance of this occurring is greater if you smoke cigarettes. Patients are advised to stop smoking, if they are planning to undergo jaw surgery. 4 Re-adjustment of the bite: Occasionally the team may suggest that you would benefit from a second operation to adjust the bite. This is generally rare, and the benefits of this would be discussed with you. Relapse after surgery: This is unusual. However, there may be a relapse in the position of the jaws or the teeth. When this occurs it does not usually require a further operation as the changes tend not to be significant.
Most patients stay in hospital for one night, and need between 2 and 4 weeks off work/ college/university. The speed of recovery varies from patient to patient. You will probably be swollen after the operation with the swelling of the face at its worst 36-48 hours after the operation. This usually improves over the following 2 to 3 weeks with your final facial appearance being apparent over a few months. The amount of change in your facial appearance will depend on whether your surgery was planned to have minimal or a more noticeable effect on your appearance. It is not unusual for patients to feel down after the surgery. It can take time for patients to get use to their new bite and facial appearance. We can arrange for you to have the appropriate psychological support if required. Care after the surgery We encourage you to start drinking and eating soft foods after the surgery. Most patients lose some weight after surgery, so it is important you make an effort to keep up your calories. 5 Your mouth opening will be reduced after surgery owing to swelling, so you should eat soft foods (soups, smoothies, yogurt etc.) Over the next few weeks you should return to a normal diet, avoiding hard foods for up to six weeks whilst the jaw bones heal. Tooth brushing is very important throughout treatment but especially so after surgery. You are advised to use a soft toothbrush for the first few weeks after surgery. We will give more detailed practical advice before surgery and also before you leave the hospital to go home. We usually review patients weekly after the surgery for 2 to 3 weeks.
We will be able to answer any questions at your next clinic appointment. You may find it helpful to bring a family member with you. Should you have any further questions or concerns, please do not hesitate to contact the orthodontic department on the contact number provided below.