Jaw surgery — clinically known as orthognathic surgery — is a procedure that repositions one or both jaws to correct significant skeletal discrepancies that cannot be resolved with orthodontic treatment alone. The decision to pursue jaw surgery is not taken lightly: it is a significant procedure with a meaningful recovery period, and it is recommended only when there is a genuine functional or health reason that the correction is necessary, not simply for aesthetic preference. At Al Safwa Medical Center in Bani Yas, Abu Dhabi, the jaw surgery team within the maxillofacial department manages the full spectrum of jaw surgical procedures — from orthognathic correction of jaw discrepancies to surgery for obstructive sleep apnoea, jaw trauma, and structural jaw pathology.
This guide explains what jaw surgery is, who needs it, what the procedure involves, and what recovery looks like. If your concern is specifically related to jaw pain and clicking rather than jaw position, the guide to TMJ disorder treatment is likely more relevant to your situation.
What is jaw surgery and who needs it?
Orthognathic surgery corrects the position of one or both jaws when the skeletal discrepancy between them is too significant to be managed by orthodontics alone. The lower jaw (mandible), the upper jaw (maxilla), or both can be repositioned — moved forward, backward, upward, downward, or rotated — to achieve proper bite function, improved facial balance, and relief of functional problems caused by the jaw misalignment.
The key distinction between orthodontic treatment and jaw surgery is what they can and cannot correct. Orthodontic treatment moves teeth within the jawbone — it can significantly improve dental alignment and bite, but it cannot change the underlying position of the jaw bones themselves. When the skeletal relationship between the upper and lower jaws is severely discrepant, orthodontic treatment alone will either be unable to achieve a functional bite, or will require compromises that produce a less stable or aesthetically poor result. Jaw surgery addresses the skeletal issue directly.
Conditions treated with jaw surgery
Significant underbite
When the lower jaw is positioned significantly forward relative to the upper jaw — causing the lower teeth to sit in front of the upper teeth — orthodontics can address dental compensation to a degree, but severe skeletal underbite requires surgical setback of the lower jaw, advancement of the upper jaw, or both. Underbite affects biting and chewing function, speech, and in severe cases, the appearance of the lower face.
Significant overbite or overjet
A severely retruded lower jaw — where the lower teeth bite significantly behind the upper teeth, or where the upper front teeth are positioned far forward of the lower — can cause functional difficulty with biting, increased vulnerability of the upper front teeth to trauma, and characteristic facial profile changes. Surgical advancement of the lower jaw is the definitive treatment for skeletal cases.
Open bite
An open bite — where the upper and lower teeth do not meet when the back teeth are closed — prevents normal biting and chewing. Skeletal open bite with a vertical jaw discrepancy is one of the most challenging problems to manage with orthodontics alone and typically requires surgical repositioning of the upper jaw (Le Fort I osteotomy) to close the vertical gap.
Facial asymmetry
Significant facial asymmetry — where the lower jaw or both jaws are visibly off-centre relative to the skull and midface — can affect both function and self-perception. Surgical correction repositions the jaw(s) to achieve structural symmetry alongside functional bite correction. Minor asymmetry is not an indication for surgery; significant functional and structural asymmetry with bite consequences is.
Obstructive sleep apnoea
In patients with moderate to severe obstructive sleep apnoea whose anatomy includes a retruded lower jaw contributing to airway narrowing, maxillomandibular advancement surgery — simultaneous forward repositioning of both jaws — significantly enlarges the posterior airway space and can eliminate or substantially reduce apnoea severity. This is one of the most effective surgical treatments for obstructive sleep apnoea in appropriately selected patients.
Jaw tumours and cysts
Structural jaw pathology — benign tumours, large cysts, or pathological fractures — may require surgical resection and reconstruction of affected jaw segments. This is managed by the maxillofacial team as part of the broader scope of jaw surgery.
How jaw surgery works: the procedure
Orthognathic surgery is performed under general anaesthesia as an inpatient procedure. All incisions are made inside the mouth — there are no visible external scars on the face. The specific surgical technique depends on which jaw is being operated on and the nature of the correction required.
Lower jaw surgery (bilateral sagittal split osteotomy — BSSO). The lower jaw is carefully cut on both sides behind the wisdom teeth, allowing the tooth-bearing segment to be moved to the planned position — forward, backward, or rotated. Once in the correct position, the bone segments are stabilised with titanium plates and screws.
Upper jaw surgery (Le Fort I osteotomy). The upper jaw is separated from the rest of the facial skeleton at a horizontal cut through the bone, allowing it to be repositioned — moved upward, downward, forward, backward, or tilted. Bone grafts may be required to fill gaps when the jaw is moved forward or downward. Titanium plates and screws stabilise the new position.
Double jaw surgery (bimaxillary osteotomy). Both jaws are operated on in the same surgical session — providing the greatest precision in achieving the planned result and avoiding the compensatory dental and skeletal changes that occur when only one jaw is corrected.
Orthodontics before and after jaw surgery
Jaw surgery almost always requires orthodontic treatment both before and after the procedure. Pre-surgical orthodontics — typically lasting twelve to eighteen months — removes the dental compensation that has built up over years in response to the jaw discrepancy, aligns the teeth within each jaw, and coordinates the upper and lower dental arches so that when the jaws are surgically moved to their correct skeletal positions, the teeth will meet correctly.
After surgery, post-surgical orthodontics — typically six to twelve months — fine-tunes the bite and addresses any remaining dental alignment. The entire treatment journey from beginning of pre-surgical orthodontics to completion of post-surgical orthodontics typically takes two to three years. This is a significant commitment, and patients who approach it with realistic expectations of the timeline consistently report satisfaction with the outcome.
Recovery after jaw surgery
Recovery from orthognathic surgery follows a predictable pattern, though individual variation exists:
Days 1–5. Significant facial swelling is expected and peaks around day 3. Pain is managed with prescribed analgesia. A liquid diet is maintained. Most patients are discharged from hospital within one to two days of the procedure.
Weeks 1–3. Swelling reduces progressively. A soft diet is maintained — nothing that requires significant biting force. Light activity is appropriate. Most patients are off work for two weeks, though this varies by the nature of the work.
Weeks 4–6. The jaws begin to feel more natural. Soft foods that require some chewing can be reintroduced. The final bite relationship begins to stabilise.
Months 3–6. The majority of swelling has resolved. The face begins to reflect the final result. Hard foods can typically be reintroduced. Post-surgical orthodontic treatment continues.
6–12 months. Complete bone healing. Final bite refinement through orthodontic treatment. Full assessment of the surgical outcome.
Is jaw surgery painful?
Jaw surgery is performed under general anaesthesia, so there is no pain during the procedure. Post-operative discomfort in the first week is significant and managed with prescribed pain relief. Most patients find the experience more uncomfortable than painful in the classical sense — the combination of swelling, restricted jaw movement, and the liquid diet are more challenging than the pain itself. By week two, most patients are managing well on standard over-the-counter analgesia. The Healthline patient guide to orthognathic surgery confirms that discomfort peaks in the first 72 hours and reduces substantially over the first two weeks.
Considering jaw surgery in Abu Dhabi?
At Al Safwa Medical Center in Bani Yas, Abu Dhabi, the jaw surgery team within the maxillofacial department works closely with the orthodontics team to plan and deliver combined orthodontic-surgical treatment. The assessment process — clinical examination, imaging, treatment simulation, and joint planning between surgeon and orthodontist — is the foundation of a predictable outcome.
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The Al Safwa maxillofacial team provides a comprehensive clinical assessment and clear explanation of the treatment plan — including the orthodontic phase, the surgical procedure, recovery, and the expected outcome — before any commitment is made.
Frequently asked questions
Who needs jaw surgery?
Patients with significant skeletal jaw discrepancies — severe underbite, severe overbite, open bite, or facial asymmetry — where the jaw position cannot be adequately corrected with orthodontics alone. Jaw surgery may also be indicated for obstructive sleep apnoea with a contributing jaw anatomy, and for jaw tumours, cysts, or structural pathology requiring surgical management.
How long does jaw surgery recovery take?
Most patients are comfortable enough for light work and social activities within two weeks. A soft diet is maintained for approximately six weeks while the bone heals. Complete bone healing takes three to six months. The full treatment journey — including pre-surgical orthodontics, surgery, and post-surgical orthodontics — typically spans two to three years from start to finish.
Are the results of jaw surgery permanent?
Yes. Once the bones have healed and stabilised — typically by six months post-operatively — the new jaw position is permanent. The titanium plates and screws used for fixation remain in place permanently and do not cause problems for the vast majority of patients. The bite result is maintained with the completion of post-surgical orthodontic treatment and retention.
Can jaw surgery be done without braces?
In rare and specific circumstances, jaw surgery can be performed without pre-surgical orthodontics — a technique called “surgery first.” This is appropriate in select cases where the dental alignment is good and the primary concern is the skeletal position. However, the majority of patients benefit from pre-surgical orthodontic preparation to achieve the best functional bite result after surgery. Your surgeon and orthodontist will recommend the appropriate sequencing for your case.
What is the difference between jaw surgery and TMJ treatment?
Jaw surgery (orthognathic surgery) repositions the jaw bones to correct skeletal discrepancies — it addresses the structural position of the jaws. TMJ treatment addresses dysfunction of the jaw joint itself — typically disc displacement, muscle pain, bruxism-related damage, or joint inflammation. The two are related but distinct: some patients with jaw discrepancies also have TMJ symptoms, and some orthognathic surgery cases improve TMJ symptoms as a secondary benefit of correcting the skeletal relationship.
