What is double jaw surgery?

Double Jaw Surgery simply means that a patient is having surgery on both their upper (maxilla) and lower (mandible) jaws.  This is the most common scenario for patients requiring orthognathic (jaw) surgery.  Typically, a single jaw surgery could be performed to align the teeth and improve the occlusion (bite).  However, to maximize the occlusion, esthetics, and airway both jaws typically require surgery. This is because double jaw surgery allows us the ability to place each jaw in its ideal position to improve the condition being treated and achieve the goals of the patient. With single jaw surgery, the jaw having surgery must be placed to meet the position of the other jaw in order to allow the teeth to fit and not necessarily in the ideal position.

This is where a detailed patient evaluation, records, and discussion (90 minutes in our office) is key.  This allows both the patient and the surgeon to better understand what is possible and what is desired.  Frequently, patients are unaware of possible changes that can occur with jaw surgery (nose size and shape, jaw angulation, cheek bone prominence, improved airway, and others) and thus are surprised and then eager to perform double jaw surgery rather than merely having the teeth fit.

Double jaw surgery is also the surgery of choice for patients who have Obstructive Sleep Apnea (OSA), snoring, or Upper Airway Resistance Syndrome (UARS).  By performing double jaw surgery, it allows the surgeon to position the jaws in the ideal position to maximize esthetics and airway instead of being limited to single jaw surgery that requires the jaw being operated on fit the other jaw. Frequently this involves advancing both jaws and performing counterclockwise rotation to maximize airway enlargement.

In addition to double jaw surgery, chin surgery (or genioplasty) is frequently performed to maximize esthetics and airway.  An advancement or reduction genioplasty can be performed to increase or decrease the projection of the chin as needed to assist the esthetic outcome if the jaws are being moved forward or backwards. For airway cases, a genial tubercle advancement can be performed (with or without traditional genioplasty) to assist in further opening the airway while balancing esthetics.

In our practice, almost every jaw surgery patient is instructed to plan for double jaw surgery since this allows us all to prepare mentally, financially, and from a recovery standpoint that both jaws may require surgery.  This also allows us to complete an insurance pre-authorization on your behalf for both jaws.  Then, as we get closer to surgery, if we all feel that single jaw surgery is preferred, we simply do less without any hiccups.