changing the face from within

Orthognathic surgery is performed using maxillofacial surgery techniques that allow the specialist to modify the position, shape and size of the maxillary bones. It is performed through invisible incisions in the mouth, through which the maxilla, chin and mandible are accessed. From there, various types of osteotomies, i.e., cuts in the bone, are made. The objective is to bring the bones into the desired position and fix them, by means of an osteosynthesis system, in the previously planned position.

Orthognathic surgery in combination with other aesthetic techniques.

This surgical intervention achieves significant changes in the face, without leaving any external scarring. In addition, there are bimaxillary advances that have a projection effect and, consequently, facial rejuvenation.

The different methods can be complemented with other aesthetic techniques, such as malar prostheses and fillers. On the other hand, this type of surgery has become one of the most recommended options for the treatment of patients with sleep apnea.

Finally, orthognathic surgery can be applied in combination with orthodontic treatment, either pre- or post-operatively, which collaborates with the goal of aligning the teeth.

Virtual planning in orthognathic surgery

In relation to this type of surgery, various technological developments have appeared over time, including virtual planning with 3D systems, the use of material manufactured specifically for the patient (PSI) and the use of cutting guides that allow the exact replication of the planning that has been performed on the computer.

In addition, there are other advances such as the individualization of temporary treatment protocols and the use of new instrumentation, such as the piezoelectric scalpel, which allows minimally invasive procedures to be performed.

Types of orthognathic surgery

There are several types of orthognathic surgery:

– Surgery on the upper jaw: the most commonly used technique is the lefort 1 osteotomy, which can help correct receding jaws (very flat faces), very long jaws (gummy smile or excessive gingival exposure) and open bites (when there is a lack of contact between lower and upper teeth).

– Jaw surgery: the most frequent technique is the branch sagittal osteotomy (BSSO). It consists of making a cut behind the last molars, thus allowing the anterior part of the mandible to move as a single unit.

– Chin surgeryMentoplasty: mentoplasty can correct delayed or advanced chins, with little projection or very long. It is performed through a small incision between the lower canines and a cut is made below the roots of the teeth, which allows to mobilize the chin.

Orthognathic surgery and rhinoplasty

Patients with jaw problems often also have alterations in their nose. To obtain an optimal result, we can combine both procedures, often in a single intervention.

Orthognathic surgery: postoperative period

This surgical procedure is performed in a hospital and, in most cases, requires a hospital stay of 24 to 48 hours. Minor procedures such as mentoplasty, SARPE or rhinoplasty can be done on a short-stay or day-hospital basis.

The questions that most concern patients are “Will I be able to open my mouth?” or “Will it hurt?”. In that sense, the main advantage of this technique is the absence of pain during the postoperative period. Although there is some discomfort for the patient, they rarely complain of severe pain. In addition, thanks to miniplate fixation techniques, the patient is able to speak and eat from the first day.

The Dr. Javier González Lagunas is Head of the Oral and Maxillofacial Surgery Department at Hospital Quirónsalud Barcelona. Qmax has become a reference center and has a team made up of top-level maxillofacial surgeons and dentists, who work in a multidisciplinary manner offering highly complex treatments. It is located in the upper area of Barcelona, in the Quironsalud Hospital, next to exit 6 of the Ronda de Dalt.