About Jaw Surgery And Why To Avoid It

What is Orthognathic (Jaw) Surgery?

Orthognathic surgery refers to surgical procedures designed to reposition the upper jaw (maxilla), the lower jaw (mandible), or both (known as bimaxillary surgery). These operations are performed by oral and maxillofacial surgeons in hospital settings under general anesthesia. The procedure involves cutting jaw bones, repositioning them, and securing them in place with titanium plates, screws, or wires.

Why Do People Get Jaw Surgery?

Common reasons patients receive surgery recommendations:

• Bite problems (malocclusion) — overbite, underbite, crossbite
• Facial asymmetry or disproportion
• Speech difficulties
• Chewing and swallowing issues
• Sleep apnea (severe cases)
• Cosmetic concerns about profile or symmetry

These reasons often involve subjective aesthetic judgments or mild issues addressable through less invasive methods.

Who Gets Jaw Surgery?

Typically recommended for teenagers and young adults after facial growth completion. Most common for significant bite misalignments that orthodontics alone cannot fully correct. Often patients are referred by orthodontists during or after braces treatment, or pursue it for cosmetic reasons.

How is Jaw Surgery Performed?

The procedure involves four steps:

1. General anesthesia
2. Bone cutting (osteotomy) — surgeon saws through jawbone(s)
3. Bone repositioning — moving jaws to new angle/location
4. Fixation — metal plates and screws secure bones in new position

Thinking About Jaw Surgery? Read This First

Jaw surgery is major bone surgery with permanent consequences:

• You cannot reverse the decision if outcomes are unsatisfactory
• Nerve damage is common and often irreversible
• Many patients report worse chewing, speaking, and pain afterward
• Some never feel comfortable with their new face
• Depression and regret are more common than surgeons admit

If the issue isn't life-threatening, keeping your natural jaw is often the safest choice.

The Dangers of Jaw Surgery

Serious, life-altering risks include:

• Permanent nerve damage (numbness, tingling, burning pain in lips, cheeks, tongue)
• Chronic jaw pain and temporomandibular joint disorder (TMD)
• Difficulty chewing and swallowing — sometimes worse than before surgery
• Speech impairment
• Relapse (jaws shift back toward original position)
• Infection and bone healing problems
• Mental health decline (depression, anxiety, regret, body image distress)
• Loss of bite strength and stability
• Altered facial identity feeling unnatural or uncomfortable

The face is "one of the most complex, sensitive, and highly integrated regions of the human body" with dense networks of sensory nerves, muscles, and joints. Complications are "not rare accidents, but rather an expected risk."

"Orthognathic surgery is too complicated, too invasive, too time-consuming, too expensive and too unpredictable." — Professor William Bell, described as "the Godfather of orthognathic surgery"

Alternatives to Jaw Surgery

Doing Nothing at All

In many cases, no intervention is best. Many identified "problems" fall within natural variation and don't cause serious health issues. Surgery may create problems worse than original concerns. Accepting your natural bite and appearance is often safer than a high-risk, irreversible operation.

Orthodontics (Braces or Clear Aligners)

Can correct a wide range of bite problems including crowding, spacing, overbites, underbites, crossbites. Cannot move actual bone structure but often sufficient for better alignment. Works gradually through gentle, controlled pressure on teeth.

Myofunctional Therapy

A specialized exercise program retraining tongue, lips, and face muscles. Helpful for open bites, tongue-thrusting habits, jaw tension contributing to misalignment and breathing issues. Non-invasive, done at home under professional guidance, works best combined with orthodontics.

Physical Therapy for TMJ

Addresses temporomandibular joint pain, clicking, restricted movement without altering jaw structure. Techniques include manual therapy, posture correction, ultrasound, guided jaw exercises. Addresses functional problems directly without creating new ones from surgery.

Dental Prosthetics

Uses crowns, veneers, or reshaping (equilibration) to improve how teeth come together. Corrects minor misalignments, restores bite stability, enhances smile aesthetics. Less invasive than bone surgery, tailored to individual dental structure.

Lifestyle Changes

For sleep apnea, jaw tension, teeth grinding (bruxism), lifestyle changes can have a powerful impact. Weight management, better sleep positioning, stress reduction, and oral appliances like mandibular advancement devices can dramatically improve symptoms.

Cosmetic Dentistry

Veneers, bonding, gum contouring, teeth whitening can improve smile harmony without altering bone structure. Minor adjustments to tooth size or shape can improve facial balance and self-confidence.

Facial Muscle Exercises

Targeted exercises improve jaw mobility, strengthen weak areas, bring greater balance to facial appearance. Help with mild asymmetry, jaw fatigue, poor posture contributing to bite issues.

Risks vs. Alternatives

Can You Just Live Without Surgery?

Many people with imperfect bites or asymmetrical faces live full, healthy lives with no functional problems. Perfection is not required for comfort, health, or confidence. The human jaw is adaptable and people with jaw variances usually eat, speak, and breathe fine. Minor functional inconveniences rarely justify the costs of jaw surgery.

When to Say 'No'

If jaw issues are mostly cosmetic, mildly functional, or already manageable, surgery often does more harm than good. The safest choice may be keeping your natural jaw and addressing concerns through less invasive means.

Bottom Line: Why You Should Avoid Jaw Surgery

Jaw surgery is often marketed as a path to improved function and beauty, but for many patients it leads to chronic pain, worsened function, and psychological harm. Seek multiple second opinions, research patient outcomes, and employ non-surgical alternatives.

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