In humans, optimal speech and eating function can only be achieved with a proper alignment of the upper and lower jaws that allows for a healthy bite and occlusion. When the mouth is closed, the teeth in the lower jaw (mandible) should fit into their proper sockets behind the teeth in the upper jaw (maxilla) (normal bite or occlusion). If the bite deviates from this norm (malocclusion), it can cause problems with speech and eating functions, as well as leading to deformities in both temporomandibular joints that can progress over time and cause significant problems. Furthermore, a lower jaw that is positioned further back than normal (Class II malocclusion) or further forward (Class III malocclusion) can seriously negatively affect facial appearance and lead to decreased self-confidence.

Treatment for bite disorders is primarily done in two ways. The first is non-surgical treatment performed by orthodontists who have completed orthodontics specialization at dental school. Mild bite disorders can be treated this way. The second treatment option is surgery. It is important to remember that the patient needs to be prepared for surgery with the assistance of an orthodontist. Orthodontic treatment before surgery can last up to a year, during which time the patient, orthodontist, and plastic surgeon are in constant communication. The type of surgery to be performed is finalized at the end of orthodontic treatment; intervention may be limited to the upper jaw, the lower jaw, or both jaws. In addition, in some cases, chin surgery (genioplasty) may be necessary to achieve optimal facial proportions.

The surgery is performed under general anesthesia and takes between 2 and 5 hours, depending on the extent of the procedures. All interventions are performed through incisions made inside the mouth. The majority of cases that come to our clinic are candidates for “double jaw” surgery, which requires cutting and fixing both the upper and lower jaws in their correct positions. In this surgery, usually an incision is first made inside the mouth for the upper jaw, and the jaw is separated from all its bone attachments. Then, an interdental splint prepared by the orthodontist is attached to the jaw, and the upper jaw is fixed in its correct position using titanium plate screws. Following this, the lower jaw is accessed, separated from all its bone attachments, and fixed in its correct position with the help of the final splint.

At the end of the surgery, it is checked that the correct bite has been achieved, and the patient is taken to their bed. Patients stay in the hospital for 2 or 3 nights after the surgery, during which time they receive appropriate treatment to reduce swelling, and their jaws are connected with rubber bands to ensure their teeth are in the correct position before they are discharged to see their orthodontist.

Following discharge, follow-up appointments by a plastic surgeon and orthodontist begin, just as before the surgery. The orthodontist monitors the patient during the healing period, focusing on modifications to ensure optimal healing, primarily maintaining the fusion of the upper and lower jaws. The plastic surgeon monitors surgical aspects such as the healing of suture lines and the reduction of facial swelling. Generally, patients can return to their routine lives within 3 weeks after surgery, and the final results can be observed between 3 and 6 months after the facial swelling has completely subsided.

Orthognathic surgery is one of the most challenging surgeries in plastic surgery, yet it is also one of the most rewarding. Besides the complexity of the surgery, complications requiring additional surgical interventions can occur. Considering the preparation period, which can last up to a year before the surgery, and the recovery period, which can last nearly a month afterward, the patient should discuss the matter thoroughly with their doctor and make a clear decision about whether they truly want to embark on this path. Although the journey is quite arduous, the aesthetic and functional results obtained after a successful surgery are extremely satisfying.