Lower (Mandible) Surgery

Mandibular osteotomy surgery AKA (Lower Jaw Surgery) corrects a severely receded lower jaw. During the procedure, qualified Oral and Maxillofacial surgeons move the lower jawbone forward or backward, depending on the patient’s bite alignment.  

How is the procedure performed?

A mandibular osteotomy can correct:

• Receding lower jaw
• Protruding lower jaw

Dr. Bolourian makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.

How long does it take to recover from lower jaw surgery?

The initial healing takes approximately 7-10 days. Even though healing and recovery is patient dependent, most patients completely heal within 6-12 weeks. If you have braces, the orthodontist may need to further align your teeth and complete orthodontics treatment.

Is lower jaw surgery considered a major surgery and is it safe?

Lower jaw surgery recovery and post operative care is generally easier for the patient than the upper jaw surgery. However, it is considered a serious and tedious procedure which demands skills and experience for a good outcome. We encourage you to do your research to find a surgeon that performs orthognathic surgery on regular basis and has hospital affiliations. Dr. Bolourian is on active staff on Memorial Care Medical Center and performs orthognathic surgery procedures routinely. In general lower jaw orthognathic surgery is a safe procedure when performed by experienced surgeons.

Is the mouth wired shut after Orthognathic Surgery?

Dr. Bolourian generally does NOT wire the mouth shut after orthognathic surgery. Elastics (rubber bands) are typically used to guide the jaw into position. The rubber bands stay on for a couple of weeks. At times no rubber bands are used and patient is able to eat soft solid food immediately after lower jaw surgery.

What are the different types of lower jaw surgery?

Depending on the diagnosis and treatment planning, lower jaw surgery can vary. The three major types of lower jaw surgeries performed at our center consist of 

• Bilateral Sagittal Split Osteotomy (BSSO)-Primarily used for mandibular advancement (to bring the lower jaw forward) surgery. However, this procedure can be used to set the lower jaw back. Both have their indications and advantages. The main advantage of BSSO is the ability to avoid wiring the jaw shot since plates and screws are used to stabilize the jaw. One main disadvantage of the BSSO procedure is its high rate of lip and chin numbness.
• Intra-oral Vertical Ramus Osteotomy (IVRO)-This procedure is primarily used to set the jaw back. Its main advantage is the low incidence of lower lip and chin numbness. The drawback is the surgeon is obligated to wire the mouth shut for some time between 4-6 weeks. There are no plates and screws used to stabilize the jaws at the time of surgery.

• Reduction Genioplasty-This procedure is primarily used to reduce a protruding chin. It is either performed as a standalone procedure or in conjunction with other jaw surgeries. There are no scarring on the face since the procedure is performed via an incision within the oral cavity. Once the chin is placed in a predetermined desired position, it is stabilized with plates and screws.

• Advancement Genioplasty-This procedure is designed to advance a deficient or small chin. It provides facial harmony naturally without the use of implants. This procedure is also performed standalone or in conjunction with other jaw surgery procedures. Similar to reduction Genioplasty, the small incisions are made through the oral cavity, once the chin is placed in the desired and predetermined position, it is stabilized with plates and screws.