Orthognathic surgery: price, procedure and results

Although it may not seem so at first glance, the individual facial structure is largely determined by the shape, placement and arrangement of the jaw. Unfortunately, dentofacial deformations, that is, a series of dental and maxillomandibular abnormalities affect 5% of the world population.

Disharmonies or dentofacial deformities affect patients who suffer them in three main blocks: functional, aesthetic and psychological. The misplacement of any maxillofacial structure can compromise breathing, swallowing, chewing, speech and, in addition, cause multiple insecurities that can transform into psychological disorders in the long term term.

For all these reasons, we tell you the following: if you belong to the 5% of the population named above, your condition has a solution. In the following lines we will tell you everything about orthognathic surgery, including price, procedure, expected results and possible adverse effects. Do not miss it.

• We recommend you read: "What is maxillofacial surgery and in which cases is it indicated?"

What is orthognathic surgery?

Orthognathic surgery is defined as a procedure designed to correct jaw and face conditions related to malocclusion problems due to skeletal disharmonies, temporomandibular joint (TMJ) disorders, sleep apnea and other functional and physiological problems of this nature.

This type of surgery is used in approximately 5% of the general population to correct the problems described above. In general, the framework of action of orthognathic surgery can be summarized in the following points:

• Correct macroscopic discrepancies of the jaw.
• Solve skeletonofacial discrepancies associated with sleep apnea (stoppage of breathing while the patient sleeps).
• Put an end to skeletal-facial discrepancies associated with the TMJ: correct problems when biting, chewing and swallowing, for example.
• Correct facial asymmetries associated with the jaw and maxilla.
• Repair facial injuries or birth defects.

Normally, patients who decide to undergo orthognathic surgery have been previously evaluated by a orthodontist, who has ruled that the procedure necessary to fix the problem is beyond their control. competencies. Therefore, usually the individuals who put themselves in the hands of the surgeon already have an idea of ​​which process will be most useful to them.

Types of orthognathic surgery

We can divide orthognathic surgery into 3 large blocks, although there are many more procedures contemplated. We tell you about them in the following lines.

1. Orthognathic surgery of the maxilla

The maxilla is a facial bone with 4 faces, edges and angles and is considered the most important bone structure of the viscerocranium. Orthognathic surgery of the maxilla, as its name suggests, is responsible for place the jaw in the correct position so that facial harmony and recovery of its functionality can be achieved. This will bring processes such as breathing, chewing, and speaking back to normal.

According to the sources consulted, the type of procedure and its invasiveness vary, but in In general, the least cumbersome intervention possible is sought and a surgical action time of about 40 minutes.

2. Mandibular orthognathic surgery

The mandible, also called the lower jaw, is an odd, flat, central and symmetrical horseshoe-shaped bone located on the front, back, and bottom of the face. The most common mandibular orthognathic surgery of all is that of mandibular advancement, seen in people with a small and retracted jaw from the upper jaw. This clinical picture generates significant facial disharmonies and makes breathing difficult in some cases (sleep apnea), which is why it requires treatment.

3. Maxillomandibular orthognathic surgery

As the name suggests, in this case repositioning of the maxilla and mandible is required, in order to create an aesthetic and functional structural pacing in the patient. This is the way to go when monomaxillary surgery (the two previously described) cannot solve the patient's problem on their own.

General procedure

As you can imagine, each of the aforementioned variants will present different steps and considerations. Even so, we can combine a general procedure that briefly describes the passage through the operating room. Go for it.

Once the patient is diagnosed with a dentofacial deformity, the orthodontist and surgeon will work together jointly to achieve the desired end: regularize your situation both aesthetically and functionally (occlusion). The preoperative process can be time consuming and costly, as the individual undergoing surgery often has to wearing braces for 12-18 months in order to align the teeth and prepare the maxillary structures before the operation.

In addition, during this time, multiple tests will be performed on the patient, including X-rays and 3D models of their maxillofacial structure. We are facing an invasive procedure with slow recovery, which is why every possible preparation is essential.

In general, most orthognathic procedures are performed under general anesthesia and require the hospital stay of the patient for 2-4 days after the operation. During surgery, the specialist cuts the maxillofacial bones and repositiones them in the desired place. Once this translocation has been made, the bone will be fixed in its new position using bone plates, screws, rubber bands, and other elements. These tiny materials will become part of the patient's bone structure over time.

Possible complications and side effects

It should be noted that, in most cases, the procedure is performed intraorally. This prevents the appearance of facial marks and scars, but sometimes these may be necessary. Even so, the patient's life will change drastically for at least 1-2 months after the operation at a dental, psychological and nutritional level, which is why Which is to arm yourself with patience and assume that it is common to experience pain, difficulty eating and strange sensations due to a "new" structure facial.

After the operation, it is necessary to make multiple nutritional adjustments, maintain strict oral hygiene, avoid the consumption of alcohol and tobacco, taking pain relieving medications and resting at home for 1-3 weeks before regaining life normal. The evolution of the patient will be monitored by the specialists involved at all times.

Here is a list of possible complications that may occur during the operation:

• Loss of blood: 30% of maxillomandibular orthognathic surgeries require a blood transfusion at some point during the operation.
• Infection: A very rare complication, as intravenous and oral antibiotics are applied to the patient throughout their recovery.
• Nerve damage: Some facial nerve structures could be compromised during the operation.
• Mandibular relapse to the position he presented before the procedure. Due to internal bony fixation, it is difficult for this to occur.
• Mandibular fractures: Very rare, as less than 2% of patients undergoing the procedure experience them.

What to expect from surgery

Correcting the alignment and location of the maxillofacial structures already described can lead to several positive patient outcomes. Among all of them we find the following:

• A balanced appearance in the lower part of the face.
• Improved function of tooth structures: chewing, swallowing and speaking.
• Improvement of certain impediments when speaking.
• An improved appearance, which leads to a stronger self-esteem in the patient.

Of course, the first objective of orthognathic surgery is to address the physiological problems derived from dentofacial deformity. Even so, we must not underestimate the aesthetic component: facial asymmetries can cause complexes in the patient that can be associated with certain emotional disorders, which is why undergoing orthognathic surgery solely for cosmetic reasons is one more option than valid.

Resume

As you may have read in these lines, orthognathic surgery is no small feat. The patient has to prepare for one or more years before the procedure both physically and psychologically, because his face is going to be modified without return.

In addition, the procedure may require blood transfusions, intravenous antibiotics, and other accessory treatments. Recovery time is slow and relatively expensive, so be patient and strictly follow the recommendations of the professionals. Even so, once performed, orthognathic surgery usually does not present complications and the patient's quality of life improves considerably. We have exposed you the information: now, you decide.

Bibliographic references

• What is orthognathic surgery? Maxillofacial Institute. Picked up on November 28 at https://www.institutomaxilofacial.com/es/cirugia-ortognatica/que-es-la-cirugia-ortognatica/
• Dentofacial disharmonies, maxillofacialimplantes.com. Picked up on November 28 at https://www.maxilofacialeimplantes.com/cirugia-maxilofacial-mexico/deformidad-dentofaciales/
• Fujikami, T. K. (2004). Retrospective statistical study of adult patients undergoing orthognathic surgery at the Hospital de Especialidades el CMN Siglo XXI of the IMSS, during the period from 1999 to 2001. Journal of the Mexican Dental Association, 61 (2), 45-53.
• Jaw surgery: overview. Mayoclinic.org. Picked up on November 28 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805731/
• Khechoyan, D. Y. (2013, August). Orthognathic surgery: general considerations. In Seminars in plastic surgery (Vol. 27, No. 3, p. 133). Thieme Medical Publishers.