What Is Orthognathic Surgery?

Written by Stephanie Booth
Medically Reviewed by Robert Brennan, DDS on July 10, 2025
8 min read

Orthognathic surgery is a procedure that lines up your upper and lower jaw. It’s also called corrective jaw surgery. It’s a complex surgery and recovery can be long, but getting it can help you sleep better, eat more comfortably, and feel better about how you look.

“It’s one of the most gratifying procedures I do,” says Sherard A. Tatum, MD, a facial plastic and reconstructive surgeon in Syracuse, New York. “The potential for significant improvement in facial harmony and balance is huge.”

You might get this type of surgery because of conditions like:

  • Malocclusion (your upper and lower jaw don’t fit together)
  • Prognathism (your jaw sticks out)
  • Jaw injury 
  • Cleft lip and palate
  • Sleep apnea 
  • TMJ (temporomandibular joint) disorder
  • Jaw cyst
  • Jaw tumor

If you have oral (mouth) or oropharyngeal (middle of the throat) cancer, you’ll likely need surgery to remove the tumor. That can affect how you look and how well you can eat or speak.

Jaw reconstruction after cancer treatment can help restore your face to its natural shape. It can also give you back your jaw function.

 

Different procedures can remove, replace, or reshape your jawbone. Which kind your doctor suggests will depend on the reason you need it done. 

 

Some orthognathic surgeries include:

 

Mandibulectomy

 

This surgery removes part or all of your mandible (jaw).

 

  • A partial, or marginal, mandibulectomy removes some of your jawbone.

 

  • A segmental mandibulectomy takes out a large part of your jaw. Your doctor can do another procedure right afterward to rebuild it.

 

You may need this kind of orthognathic surgery if you have:

 

  • Oral cancer
  • Oropharyngeal cancer
  • Bone infection or disease
  • Severe damage to your jaw

 

It’s a major surgery that takes hours to do. An incision (cut) is made inside your mouth. Then, the tumor is removed through it and the cut is closed.

 

Free flap reconstruction

If your jaw is being rebuilt, you’ll probably have this procedure at the same time as your mandibulectomy. Bone, tissue, and skin are taken from another part of your body, like your lower leg.  This is called a “free flap,” which is where this procedure gets its name.

 While you’re still under anesthesia (asleep and unable to feel any pain), a surgeon shapes the new bone to match your jaw. Then, using a microscope, they’ll carefully attach it to blood vessels in your head and neck. Special medical screws keep it in place, and tissue is replaced above your new jawbone.

Reconstruction plates

If a lot of your mandible is gone, sometimes a reconstructive titanium plate is used to re-create it. 

 

Some reasons you may need this type of mandible reconstruction are:

 

  • A tumor 
  • Severe trauma
  • Infection
  • Osteonecrosis (a condition that blocks blood supply to your bones)

 

During this surgery, tiny screws and other fasteners attach the pieces of your lower jaw that you still have to this special plate.  If you don’t have enough bone or tissue, it can be harvested (taken) from another part of your body.

 

Maxillectomy

 

This surgery takes out part or all of your upper jawbone (maxilla). Some of your teeth or the roof of your mouth could be removed, too. 

 

You could need this done if you have cancer in your:

 

  • Upper jaw
  • Nose
  • Sinuses
  • Roof of your mouth

 

The type of maxillectomy your surgeon does will depend on which structures they’re taking out. For instance, sometimes they can make a tiny incision in your nose and remove a tumor that way. Other times, it’s a more involved procedure. They’ll need to rebuild part of your face with another surgery.

 

Obturator prosthesis

 

If all or most of the roof of your mouth was removed, you could get a maxillectomy/palatectomy prosthesis, or "obturator." It’s a device that goes in your mouth and helps with important daily functions like eating and talking.

 

During surgery, you’ll get a temporary obturator. It’s held in place with small screws or wires. As the area heals, it will be replaced with a better-fitting prosthesis that you can put in and take out of your mouth, like dentures or a retainer.

How your jaw looks can affect the shape of your face, your teeth, and your smile. It can have a big impact on how you feel about yourself. 

Poor jaw function can also make it hard for you to do things that should come easily, like eating, speaking, keeping your teeth and mouth clean, and sleeping well.

Orthognathic surgery can improve your appearance and how well your jaw functions. Before your procedure, your doctor will help you understand what to expect.

“Computer predictions can be helpful in getting some idea of what to expect in appearance change,” says Tatum. “As long as you’re properly prepared and know what you’re getting into, the potential for patient satisfaction is high.”

Based on the extent of your surgery, you could go home the same day. “But most people will stay overnight,” says Tatum.

You could be in the hospital for several days or for a few weeks.

Generally, the recovery time for orthognathic surgery is about six weeks. But your jaw will keep healing for up to a year.

For the first 24 hours:

  • Your jaw may be closed with wires or special bands.
  • You may be groggy or have other side effects from the anesthesia.

Stay propped up. Keeping your head higher than your body will help reduce swelling in your face.

Put ice packs on your jaw. This should be done for no more than 20 minutes at a time. Make sure the ice is wrapped in a towel so you don’t hurt your skin.

For the first few weeks:

  • You may still have swelling and numbness.
  • You’ll probably need to manage pain with medications.

Rest as much as you can. During your first week, you can probably do light physical activity, like taking a walk around the block, but follow your doctor’s advice. 

Take care of your mouth. You’ll have specific steps to follow to keep your mouth and incision site clean. Don’t use straws or try to eat hard food.

Check in with your surgeon. They’ll want to keep a close eye on how you’re healing.

After three weeks:

  • You’ll probably be back to work, if you have a desk job.
  • You'll probably be able to drive, as long as you can turn your head and don’t take prescription pain medications.

What to eat after orthognathic surgery

You’ll be on a liquid diet for six to eight weeks after your procedure. It will be important for you to get enough nutrients so your body can heal. You might want to eat small amounts five to six times a day.

Some soft foods you can try:

  • Soup
  • Smoothies
  • Milk
  • Eggs
  • Greek yogurt
  • Tofu
  • Smooth peanut butter
  • Soft, cooked beans (like refried beans)
  • Liquid nutritional supplements, like Ensure or Boost 

At first, your doctor may tell you to only eat foods that have been put into a blender first. Follow their directions. Eating the wrong foods can hurt your jaw and make your recovery take longer.

The specific risks depend on which procedure you get done. They could include:

  • Damage to your teeth
  • Scarring
  • Blood clot
  • Hematoma (when blood collects under your skin)
  • Seroma (fluid buildup under your skin)
  • Infection
  • Nerve damage
  • Jaw joint pain
  • Trouble with your bite (how your teeth fit together)
  • A need for more jaw surgery

Call your doctor right away if you have:

  • A fever of 100.4 F or higher
  • Rash
  • Bruising
  • Crankiness (feeling easily upset)
  • Swelling
  • Pain that doesn’t go away or gets worse
  • Trouble breathing 
  • Throwing up
  • Diarrhea
  • Signs of infection, like skin that feels hot to the touch or oozes discharge

Many things will affect the cost of your surgery,  like whether you have health insurance, your deductible and copay, the reason you’re having the procedure, and even where it will be done.

Some health plans cover orthognathic surgery if it’s for a medical reason. Other insurers have an “exclusion” for jaw surgery, meaning they won’t pay for it, no matter what.

The best way to know what your health plan will cover is to call the number on the back of your ID card and ask. Your doctor’s office may also be able to help you understand the cost.

Orthognathic surgery corrects, restores, or replaces part or all of your jaw. A major surgery with a long recovery, orthognathic surgery has a success rate of nearly 94%. Many people who’ve had it done say they have a better quality of life. You could have it done to remove a tumor, increase jaw function, or improve your appearance.

Is orthognathic surgery major surgery?

Orthognathic surgery is a major surgery that changes the bone structure of your mouth. Because of the risks involved, it needs to be done by a highly trained surgeon. 

How painful is orthognathic surgery?

Your doctor will prescribe pain medications after orthognathic surgery. You’ll need them less as you heal. If your pain gets worse or doesn’t go away, let your doctor know right away.

How long does it take to recover from orthognathic surgery?

About six weeks after orthognathic surgery, your jaw will be done with its first stage of healing. But it won’t be completely healed for about a year. You’ll have to follow your doctor’s advice so you don’t injure it.

Is orthognathic surgery worth it?

There are many benefits to orthognathic surgery. For instance, it can make it easier for you to chew, bite, speak, or sleep. It can reduce pain in your jaw. You might like how it changes your appearance. And sometimes, it’s the only way to remove a tumor that’s harming your health.