Orthognathic Surgery Overview
Orthognathic surgery is a group of specialized procedures that correct jaw and bite disorders, and complex conditions that affect the structure of the face. It is a corrective jaw surgery that is prescribed for skeletal and dental disparities to restore both function and aesthetics. In most cases, when a condition is too severe or complex to be treated by a dentist or an orthodontist, an orthognathic surgeon is called upon to correct the problem. Typically, bones are cut and realigned and then held in place as part of the surgery using screws and/or plates. Palo Alto maxillofacial and plastic surgeon, Dr. Stephen Schendel, is a jaw surgery expert who has trained extensively to correct jaw disorders. He is a renowned expert in the field who has invented tools and techniques that are now adopted worldwide.
What It Treats
Orthognathic surgery is not only used to enhance the beauty of a smile, but more importantly is used to correct facial skeletal deformities and airway problems. Conditions treated by orthognathic surgery include:
- Facial Disharmony
- Sleep Apnea Conditions
- TMJ Conditions
- Severely Crooked Teeth
- Facial Structure Deformities
- Weak, Limited Cheek Bone
- Underbites and Overbites
- Gummy Smile
- Cleft Palate
"I had some plastic surgery done to correct my a creator on head after a traumatic event. Dr Schendel gave me a few options to consider, which resulted with excellent results."- A.K. / Google / May 09, 2018
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and..."- A.T. / Yahoo / Dec 03, 2017
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and made room in his schedule to consult regarding my 8 year-old daughter's needs when we had no prior relationship with him and oral surgery was imminent. He was gentle with her and honest with me about our choices. His expertise and care allowed me to make the best choice for my child.Secondly, he has cared for more than one individual I hold dear. This family has faced over 20 years of medical intervention and combined, upward of 30 surgeries. Dr. Schendel has been steadfast, consistent, and brilliant in his care of my dear one and her child. As her friend, each time they have faced yet another intense physical challenge or surgery, I have rest assured that she was getting the absolute best treatment because she was in Dr. Schendel's care. The bottom line is I trust him, both to care for my family and those I cherish.Aneea Toomajian PPS, LMFTEducational and Behavioral Consultant"- A.T. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to correct a severe unilateral cleft lip and palate. I was referred to him because my clefting was so unusual and other surgeons had been unsuccessful with my case. My cheekbones were non-existent, eye sockets sucken in, jaw extremely recessed, palate permanently open and I had existing scar tissue from previous cosmetic surgery attempts by another surgeon. These are ALL the things Dr. Schendel has fixed with expertise, compassion and dedication. californiacraniofacialin…Over the years, Dr. Schendel has carefully and compassionately rebuilt my face from the inside out. Giving me the bone structure that I was not born with due to the severity of my cranial facial anomalies.When I first met him(I was 14) he excused his entire team of fellows who were there to observe him. He gave me the privacy I needed, handed me a mirror and asked me, "What don't you like about your face?". As a teenager, I was given the space to communicate the things that were great sources of pain. I explained the various things about my cleft lip that caused other kids teased me about. From that moment Dr. Schendel set out to give me a normal face with nothing but determination, dedication and true compassion.Over the years, I have faced other complications with my bone structure and degeneration from my severe cleft. Dr. Schendel has fiercely, carefully and methodically worked to fix the constant erosion and instability in my face. He has striveded to continually find the newest, best techniques available. I have been able to have implants along with bone grafts to retabalize my eroding palate, stem cell procedures to improve the tissue and blood flow to my face and cosmetic revisions-- I have been incredibly grateful and happy with the results.Dr. Schendel's ability to listen and connect with me has been amazing. As a youth, I felt safe, validated and listened too as a patient. As an adult, he has heard my worries and validated the pain I have felt in my face and palate. He has worked tirelessly to fix my cranial facial anomalies. I believe that his ability to be so compassionate and careful with his patients comes from YEARS of working with cleft affected children here and in third world countries. A few years ago, I learned that Dr. Schendel has also volunteered countless hours of surgery in third world countries to operate on children. He has insisted that the surgeries are learning sessions for local doctors in those countries. He has created a learning environment to teach the newest techniques to other physicians in these countries. He also spends months of his own time collecting supplies to take to these countries to donate for the surgeries. Dr. Schendel's passion for rebuilding faces generates from a desire to truly want to help rebuild lives--physically...and emotionally.Our son is also bilaterally cleft affected, he is now 13. Dr. Schendel has revised his soft palate and his lip. It is with tremendous gratitude that we have Dr. Schendel as our son's doctor. His revision is beautiful and his cleft is a non-issue. His speech has also VASTLY improved due to the titrated listening of Dr. Schendel in knowing how to revise our sons palate so skillfully so he can now make sounds like "J" "P" "K". I have referred Dr. Schendel to several family friends for various things that are not cleft related. Not because Dr. Schendel is an incredible oral maxillary and plastic surgeon. But because of his ability to connect with his patients, to hear them, to see them and then to use his dedication to medicine to help them."- V.L. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to..."- V.L. / Yahoo / Dec 03, 2017
Types of Orthognathic Surgery
Upper Jaw Surgery
Referred to as a maxillary LeFort osteotomy (surgery of the upper jaw), this technique is used for patients who have severe misalignment of the teeth and jaw, as well as midface hypoplasia. These conditions lead to an underdeveloped upper jaw and weak cheekbones and are usually too complex to be addressed by a dentist. Technique varies from patient to patient but it is generally done in segments, where the upper jaw is surgically sectioned and repositioned. Plates are used during the surgery to hold the new positioning into place. There are variations to the LeFort procedure. Some variations are used to correct the misalignment as mentioned above, while others address conditions such as a cleft palate, upper jaw fractures and other midface deformities. The surgery can also increase the width of the arches if necessary. 3D imaging is used to help project an accurate outcome of how the face will look after surgery.
Lower Jaw Surgery
Lower jaw surgery is referred to as bilateral sagittal split osteotomy (BSSO). This procedure is designed specifically for the mandible (lower jaw). Used to correct protrusions of the lower jaw or other deficiencies, BSSO can help move the jaw forward or backward by splitting it bilaterally. Plates and screws help to keep the surgical changes in place. This surgery corrects lower jaw conditions and changes the look of the jaw and lower face so that facial harmony is balanced and stronger.
Orthognathic Surgery During/After Surgery
Orthognathic surgery is performed in-house in our accredited surgical facility. General anesthesia is used during this procedure and it can take anywhere from 2-4 hours to be completed, depending on how severe or complex the condition is. Once the bones of the chin, upper jaw, and/or lower jaw are repositioned, they may be held in place with small titanium screws and plates. Patients who fear that their mouths will be wired shut should not worry; this does not occur with jaw surgery. Rather, rubber bands or a dental splint are used to guide the patient into a new bite. This surgery requires approximately 6 weeks of limited activity. A specific post-operative program, including a diet (foods to eat while healing), will be provided.
Orthognathic Surgery Expected Cost
The cost for orthognathic surgery will vary. It can run as low as $7,000 and as high as $20,000 or more. In some cases, depending on the condition and if a medical issue is resulting, insurance may cover a portion of the procedure. During your initial consultation, our team of insurance coordinators will confirm if insurance benefits can apply to your specific procedure.
Plan Your Procedure
- Average Cost
- $4,000 - $25,000
- Recovery Time
- 2-3 Weeks
- Average Procedure Time
- 2-4 Hours
- Procedure Recovery Location
Jaw Surgery FAQs
What Should I Expect?
Our office takes great care in improving the surgical technique by coordinating pre-calculated phases prior to surgery. The pre- and post-surgical phases require imaging, articulated mounting of casts, bite registration, intermediate splint fabrication, and segmental mechanotherapy (braces). These scheduled activities can reduce the overall treatment time by more than 50%. It also helps to produce the best possible outcome for each patient.
How Will I Look?
Proprietary 3D imaging helps to create a virtual patient from scans to simulate surgery, allowing us to visualize the surgical results and collaborate on the outcome prior to surgery. This technology is accurate and also helps to calm the fears and nerves of our patients.
Successful orthognathic surgery eliminates pain, restores function, improves quality of life and boosts self-esteem for the patient, but it can also improve his or her dental health. This surgery eliminates abnormal wear and forces on the teeth, making it easier for patients to brush and floss their teeth, and allows them to maximize the effectiveness of their home care as well as the benefits of regular professional cleanings.
Can I Eat?
Eating after jaw surgery is difficult, especially in the early recovery phase. Most patients will find that they lose an average of 5-10 pounds after surgery. The first several weeks will be a liquids-only diet. This includes anything that can be pureed or blended in a blender. After the 3rd week, we recommend patients eat soft foods that can be easily smashed or squished with a fork. During the 6-8 week mark, some patients can begin to chew soft foods that are cut into small pieces. Every patient recovers at a different speed. The most important advice is to not rush the eating process, and follow the post-operative protocol instructions that will be given by our office.