Corrective jaw surgery is usually performed in a hospital or in an ambulatory surgical center. Occasionally the procedures can be performed in the office. Surgery may take from one to several hours to complete. Your surgery might involve one jaw or the two jaws (bi-maxillary or maxillo-mandibular) during the same procedure. During the surgery, Dr. Maranon will reposition the jaws so that the teeth fit together properly. This is made possible by the pre-surgical orthodontics. The modification is done by making delicate osteotomies (cuts in the bones) of the jaws and repositioning them in the desired alignment. The upper jaw can be adjusted using a “LeFort I” level osteotomy (most common). The lower jaw procedure usually performed is called bilateral sagittal split osteotomies. These procedures will allow your jaws to be moved in all three planes of space.
During surgery, the jaws may be wired together (inter-maxillary fixation) using stainless steel wires to ensure the correct re-positioning of the bones. In most cases this fixation is released before the end of the surgery. Patients may have orthodontic rubber bands in place after surgery. On very rare occasions, the jaws remain wired for a few weeks if it is felt that it is necessary for the success of surgery. Dr. Maranon will reposition the jaw in accordance with the surgical plan. In some cases, bone may be added, taken away or reshaped. Rigid internal fixation is a use of screws or plates which allows us to avoid wiring the teeth together. The surgical plates and screws will be used to hold the jaws in their new positions. These bone plates and screws are very low profile and are rarely noticed. The surgery usually does not involve cutting the skin. Dr. Maranon typically completes all his procedures from incisions in the inside of the mouth. A very small number of cases do require small incisions outside of the mouth. When this is necessary, care is taken to minimize their appearance. The length of your surgery depends on the procedure being performed. After their procedure, some patients remain in the hospital overnight. In some cases, patients can go home the same day.