Surgery
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Orthognathic Surgery (Jaw Surgery)
When?
Not everyone born with a cleft has jaw surgery. For those who do, this operation happens once your face has finished growing, usually towards the end of your teenage years or in early adulthood.
Why?
Some patients who have had cleft palate surgery find that their upper and lower jaw grow unevenly. This can make the lower jaw look like it sticks out further when seen from the side. If this bothers you, we can offer orthognathic surgery (jaw surgery) to bring the upper jaw forward. This operation is usually done to change appearance, but it can also help with other things, like improving speech and making it easier to breathe through the nose.
Are there alternatives?
This operation is not essential. It is your choice whether you would like to have it.
How?
You will be asleep for the operation. We make some cuts in the bone of your upper jaw to move it forward, then hold it in place with small plates and screws.
How Does the Decision-making Process Work?
- We won’t offer this surgery if it is something you do not want.
- We will see you in clinic and discuss what might be achieved with surgery.
- We may ask you to see our psychology team to talk about what you hope the operation will achieve. This can help us understand together whether this operation is the right one for you.
What Will Happen If I Go Ahead With Surgery?
- You will have several X-rays, and we will make moulds of your teeth, called dental impressions.
- You will need braces to get your teeth ready for the operation. This is usually for 12 to 24 months before the operation, and 6 months afterwards.
- We will tell you when to stop eating and drinking before the operation.
- If you are being treated in Manchester, you will come to (location)
- If you are being treated in Liverpool, you will come to (location)
You will stay in hospital for at least one night, so we can make sure you are comfortable and have no problems straight after the operation.
Aftercare
You will need to eat soft food for 6 weeks. You can find advice on what counts as soft food here.
This depends on how much pain you have after the operation. We recommend regular paracetamol and ibuprofen. If needed, we may also send you home with a small amount of codeine, a stronger pain medicine.
You will have some X-rays after the operation to check the new position of your jaw.
The orthodontist will see you in clinic during the first few weeks after your operation.
What Are The Risks?
This can be quite a sore operation, but we will support you in hospital and give you painkillers to take home.
Your face will usually be quite swollen after this operation. Most of the swelling goes down in the first 3 weeks, but some can last for several months.
Most patients lose some weight after surgery due to limitations in what they can eat after the operation. Your weight usually returns to normal once you return to a standard diet.
Your cheek, lip or tongue may feel numb. This is usually caused by swelling, and can take up to 18 months to improve. In rare cases, it can be permanent.
Your cheek, lip or tongue may feel numb. This is usually caused by swelling, and can take up to 18 months to improve. In rare cases, it can be permanent.
2 in every 10 patients notice their speech sounds more nasal after this operation.
Changing the position of the jaw usually changes the shape of the nose.
Most people keep the screws and plates in for life, but a small number of people need them taken out.
The jaw slips back to a similar position as before surgery in small number of people (1-2 in 10). An even smaller number of people require a second operation to correct this.
This can happen after surgery because changing your jaw position can also change the position of small tubes in your ear, called eustachian tubes.
Some complications are severe, such that we tell you about them before surgery even though they are unlikely. These include the cuts in the bone being in the wrong position (0.9%), sinusitis (up to 0.8%), jaw stiffness, bone healing problems (non-union – 0.5-1%), loss of teeth (0.19%), loss of some jaw bone (0.2%), facial weakness (0.3-0.6%) and blindness (only 9 cases reported worldwide).