Double Jaw Surgery (Bimaxillary Osteotomy): Transforming Faces and Live, An In-depth Look

What Is Double Jaw Surgery (Bimaxillary Osteotomy)?

Double Jaw Surgery, also known as Bimaxillary Osteotomy, is a surgical procedure conducted on both the upper and lower jaws to correct their alignment and size. This comprehensive procedure is typically pursued by patients with jaw discrepancies that cause functional or aesthetic challenges.

Types of Osteotomy

In the realm of jaw surgery, several osteotomy types are utilized depending on the specific needs of the patient. These include:

• Le Fort I Osteotomy: This procedure targets the upper jaw (maxilla) and can move it upward, downward, forward, backward, or a combination of these directions.
• Bilateral Sagittal Split Osteotomy (BSSO): Performed on the lower jaw (mandible), it allows the jaw to be moved forward or backward as a lower jaw surgery.
• Genioplasty: This orthognathic surgery is designed to modify the chin’s shape and position for a more balanced facial appearance.
• Bimaxillary Osteotomy: A combination of Le Fort I Osteotomy and BSSO, the Bimaxillary Osteotomy alters both the upper and lower jaws for a comprehensive correction.

What Does the Double Jaw Surgery Involve?

Double Jaw Surgery, formally known as Bimaxillary Osteotomy, is a multifaceted orthognathic surgical procedure that aims to correct irregularities in the upper and lower jaws. Here’s a detailed breakdown of the process:

• Consultation and Pre-operative Planning: Before the actual surgery, comprehensive consultation sessions with a maxillofacial surgeon and an orthodontist are held. Advanced imaging techniques, like 3D CT scans, are used to evaluate the jaw’s structure, which aids in crafting a detailed surgical plan.
• Pre-surgical Orthodontic Treatment: Patients usually undergo orthodontic treatment before surgery. This step helps align the upper teeth and lower teeth in the correct position in preparation for surgery and can range from a few months to a couple of years, depending on the individual’s needs.
• Anesthesia: The surgery is performed under general anesthesia to ensure the patient is comfortable and doesn’t experience any pain during the procedure.
• Surgical Access: An incision is made inside the mouth, minimizing visible external scars. This gives the maxillofacial surgeon access to the jaw bones.
• Osteotomy: Precise jaw bone cuts (osteotomies) are made in the upper jaw (maxilla) and the lower jaw (mandible). This allows for the free movement and repositioning of these jaw segments.
• Repositioning of the Jaws: The misaligned jaw segments are moved into their new, pre-planned positions. This step is crucial for addressing the facial asymmetry and achieving the desired facial aesthetics.
• Fixation: Once the jaws are satisfactorily aligned, they are held in place using titanium plates and screws. These fixtures provide stability and aid in the healing process.
• Additional Procedures: Depending on the patient’s requirements and the surgeon’s recommendations, additional procedures like genioplasty (chin reshaping) might be performed to enhance the overall facial harmony.
• Wound Closure: The incisions inside the mouth are meticulously sutured, ensuring proper wound closure.
• Recovery: After the surgery, patients are closely monitored in a recovery room. Once stable, they might be required to stay in the hospital for 2-4 days. Recovery involves adhering to a soft diet, taking prescribed medications, and attending regular follow-up appointments to monitor the healing process.
• Post-surgical Orthodontic Treatment: After the surgical procedure, additional orthodontic treatment may be necessary to fine-tune the alignment of the teeth and ensure optimal bite function.

While the above steps provide a general outline of the Double Jaw Surgery process, it’s essential to note that the exact details can vary based on individual cases and the surgeon’s specific approach.

Benefits of Double Jaw Surgery

The jaw problem usually causes visible problems in facial asymmetry and therefore facial aesthetics. As an operation in which jaw asymmetry can be corrected, Bimaxillary Osteotomy eliminates facial asymmetry caused by jaw problems.

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Double jaw surgery offers a host of benefits that significantly enhance the patient’s quality of life. These include:

• Correct Jaw Misalignment: It efficiently resolves open bite problems like underbites, overbites, and crossbites, leading to improved facial asymmetry as a corrective jaw surgery. 
• Correct Jaw Size: The procedure adjusts the size of the jaws to achieve proportional facial appearance.
• Balance Facial Features: By aligning the jaws properly, the surgery creates a balanced and appealing facial profile.
• Improve Jaw Function: It rectifies chewing, swallowing, and speech issues caused by jaw malformation.
• Relieve Facial Pain: It provides relief from facial pain and discomfort often associated with jaw disorders.
• Improve Obstructive Sleep Apnea: By expanding the airway dimensions, the surgery can significantly improve symptoms of obstructive sleep apnea.

Who are good candidates for a Bimaxillary Osteotomy?

Those with significant skeletal discrepancies, a malocclusion not correctable with orthodontics alone, or suffering from obstructive sleep apnea due to jaw structure, could be ideal candidates for Bimaxillary Osteotomy. 

A comprehensive consultation with a maxillofacial surgeon is vital to determine the need for any orthognathic surgery.

Double Jaw Surgery Procedure

The double jaw surgery process begins with pre-surgical orthodontics to align the teeth in each jaw. This step can take 12-18 months. The surgery itself involves precise cuts (osteotomies) in the jaw bones. The maxillofacial surgeon then repositions the jaws and secures them with tiny plates and screws. 

Post-surgery, the patient may require additional orthodontic treatment for final teeth adjustments and optimal bite function.

What Can I Expect After the Operation?

Following the operation, patients will likely experience swelling and discomfort, which is manageable with prescribed pain medications. The hospital stay could range from 2-4 days, depending on the patient’s recovery speed. Regular follow-ups are needed to monitor the healing process and progress.

Possible Risks and Complications

Like any surgery, Bimaxillary Osteotomy comes with potential risks and complications, which include:

• Bleeding: Minimal bleeding is expected post-surgery, but excessive bleeding can be a concern.
• Infection: Though rare, infections can occur and are treatable with antibiotics.
• Nerve Damage: Temporary or, in rare cases, permanent numbness or tingling in the lower lip, tongue, or chin can occur.
• Relapse: The possibility of the jaw reverting to its original position exists, though it’s quite rare with modern surgical techniques.

Double Jaw Surgery Before and After

Patients often experience a dramatic transformation in their facial aesthetics and functionality after double jaw surgery. Post-operative photographs exhibit remarkable improvements in facial harmony, jaw alignment, and overall appearance.