# Jaw Surgery and Orthodontics: What Is Orthognathic Surgery and Who Needs It? Publisher: Virtual Consultant Online Author: Virtual Consultant Online Published: 2026-08-27 Updated: 0001-01-01 Canonical URL: https://virtualconsultant.online/blog/orthognathic-surgery-uk Citation metadata: https://virtualconsultant.online/citation.json?url=https%3A%2F%2Fvirtualconsultant.online%2Fblog%2Forthognathic-surgery-uk For a small proportion of patients seeking orthodontic treatment, braces or aligners alone cannot fully correct the problem. When the issue is not just the position of the teeth but the underlying relationship between the upper and lower jaws, orthodontic appliances can move teeth but cannot change the bone they sit in. This is where orthognathic surgery — often called jaw surgery — comes in. It is one of the most transformative treatments in dentistry, capable of correcting severe bite problems, improving facial balance, and resolving functional difficulties that orthodontics alone cannot address. Yet it is also one of the most misunderstood. This guide explains what orthognathic surgery is, who needs it, what the treatment process involves, and what to expect before and after surgery — so you can understand whether it might be relevant to your situation and ask the right questions if it is. Key takeaway Orthognathic surgery is appropriate when a patient has a jaw discrepancy — a significant difference in the size or position of the upper and lower jaws — that cannot be adequately corrected by orthodontic tooth movement alone. It is not cosmetic surgery (though it often has significant aesthetic benefits): it is functional corrective surgery, typically funded by the NHS for eligible patients, performed by a maxillofacial surgeon in collaboration with a specialist orthodontist. The treatment process involves pre-surgical orthodontics, surgery, and post-surgical orthodontics — typically spanning 18 to 30 months in total. Most patients describe the outcome as one of the most significant improvements to their quality of life they have experienced. ## What Is Orthognathic Surgery? Orthognathic surgery (from the Greek: orthos = straight, gnathos = jaw) is surgical repositioning of the upper jaw (maxilla), the lower jaw (mandible), or both. The surgery is performed by a maxillofacial or oral surgeon under general anaesthetic, and involves cutting the jaw bone, repositioning it into the planned correct position, and fixing it there with titanium plates and screws. The procedure is always planned and coordinated with specialist orthodontic treatment. Orthodontic treatment before and after surgery is an essential part of the process — it is not a surgery you can have in isolation. ## What Problems Does Jaw Surgery Correct? Class III malocclusion (underbite): the lower jaw protrudes forward relative to the upper, causing the lower front teeth to sit in front of the upper front teeth. When the discrepancy is skeletal (caused by jaw size difference) rather than dental, surgery is typically needed to achieve a stable, functional result Severe Class II malocclusion (significant overjet): the lower jaw is significantly set back relative to the upper, causing a large overjet (horizontal gap between upper and lower front teeth). In skeletal Class II cases — particularly in adults where jaw growth is complete — surgery may be the only way to achieve a stable correction Open bite: the back teeth meet but the front teeth cannot come together when biting. Skeletal open bites, particularly vertical open bites, often have a skeletal cause that cannot be fully corrected by orthodontics alone Crossbite with skeletal cause: where the upper and lower jaws are offset side to side due to a difference in jaw width rather than just tooth position Facial asymmetry: significant asymmetry of the face or jaws that cannot be adequately corrected by orthodontic treatment alone Obstructive sleep apnoea: in some patients, the jaw relationship contributes to airway obstruction during sleep. Jaw surgery may form part of the surgical management of obstructive sleep apnoea Wondering whether your bite problem could be treated with orthodontics alone? A virtual assessment from a specialist orthodontist can give you a personalised view of your treatment options before you commit to any consultation. Start your free assessment → ## The Orthognathic Treatment Process: Step by Step Phase 1: Assessment and planning Referral to a specialist orthodontist and maxillofacial surgeon who work as a team Clinical photographs, dental models, and X-rays (OPG, lateral cephalogram) 3D CBCT scanning increasingly used for detailed surgical planning Digital surgical planning to simulate jaw movements and predict outcome Phase 2: Pre-surgical orthodontics Fixed braces fitted — typically 12 to 18 months before surgery Teeth are aligned within each jaw individually (not to each other) Bite may appear to worsen before surgery — this is intentional and expected Patient declared “surgery ready” when pre-surgical objectives achieved Phase 3: Surgery Performed under general anaesthetic in hospital — typically 1 to 3 nights stay All incisions made inside the mouth — no external scarring Jaw repositioned and fixed with titanium plates (these remain permanently) Significant swelling expected for 2 to 6 weeks Phase 4: Post-surgical orthodontics Braces continue for 6 to 12 months after surgery to fine-tune occlusion Braces removed when final result achieved Retainers prescribed as with any orthodontic treatment Long-term follow-up with both orthodontist and surgeon ## Is Orthognathic Surgery Available on the NHS? Yes — orthognathic surgery is one of the few adult orthodontic treatments that can be funded by the NHS. It is commissioned as a combined orthodontic and surgical package for patients who meet the clinical criteria. NHS funding is typically available when the jaw discrepancy is causing or likely to cause functional problems — difficulties with biting, chewing, speech, or breathing — and when the severity of the problem is beyond what orthodontics alone can address. Access is through referral, usually from a GDP (general dentist) to an NHS specialist orthodontist, who then coordinates with the maxillofacial surgery service. Not all areas have an NHS orthognathic service with short waiting times — waiting lists for NHS jaw surgery can be significant in some regions. ## Recovery: What to Expect First 2 weeks: significant facial swelling, a soft liquid diet, and difficulty opening the mouth fully. Most patients take 2 to 4 weeks off work Weeks 2–6: swelling gradually reduces, diet progresses from liquids to soft foods. Some temporary numbness in the cheeks, lips, or chin is common and usually resolves over several months 6 weeks onwards: most patients feel near-normal and return to most activities. A soft diet is recommended until the bone is fully healed (typically 8 to 12 weeks post-surgery) Full swelling resolution: final facial result and full resolution of swelling may take 6 to 12 months, as residual deep swelling resolves slowly Important Orthognathic surgery is a major surgical procedure that should only be considered when the clinical indication is clear and when the patient has been fully informed of the risks, benefits, and realistic expectations for the outcome. Key risks include temporary or (rarely) permanent numbness in areas of the face supplied by the nerves adjacent to the surgical sites, the possibility of needing minor revision surgery, and the time commitment of the full treatment process. For patients with the right clinical indication, however, it is a highly predictable procedure with a very high patient satisfaction rate. Always ensure your treatment is delivered by an experienced team where the orthodontist and surgeon regularly work together on these cases. Not Sure Whether Your Bite Needs Surgery or Braces? A virtual assessment from a specialist orthodontist is the best place to start — they can tell you whether your case is suitable for orthodontics alone or whether a combined approach is likely to be discussed at a face-to-face consultation. Start Your Free Assessment → ## FAQs ### What is orthognathic surgery? Orthognathic surgery is surgical repositioning of the upper jaw (maxilla), lower jaw (mandible), or both, to correct significant jaw discrepancies that cannot be adequately treated by orthodontic tooth movement alone. It is performed by a maxillofacial surgeon under general anaesthetic, with all incisions made inside the mouth (no external scarring). The jaws are repositioned and held in place with titanium plates and screws. The surgery is always combined with orthodontic treatment before and after the procedure — it is not a standalone treatment. ### Who needs jaw surgery alongside braces? Jaw surgery is needed when a patient has a significant skeletal discrepancy — a difference in the size or position of the upper and lower jaws — that cannot be corrected by moving teeth alone. Common indications include a severe underbite or large overjet caused by jaw size difference rather than just tooth position, a skeletal open bite, significant facial asymmetry, and some cases of obstructive sleep apnoea. The decision is made by an orthodontist and maxillofacial surgeon working together, based on clinical assessment, X-rays, and 3D scans. ### Is jaw surgery available on the NHS in the UK? Yes — orthognathic surgery is one of the few adult orthodontic treatments available on the NHS in the UK. It is funded when the jaw discrepancy causes or is likely to cause functional problems (difficulties with biting, chewing, speech, or breathing) and when the clinical severity warrants surgery. Access is through referral from a GDP to an NHS specialist orthodontist, who coordinates with a maxillofacial surgery service. Waiting times for NHS orthognathic treatment vary by region and can be significant in some areas. ### How long does orthognathic surgery treatment take in total? The full orthognathic treatment process typically takes 18 to 30 months from start to finish. This includes a pre-surgical orthodontic phase (usually 12 to 18 months of fixed braces before surgery), the surgery itself (1 to 3 nights in hospital), recovery (2 to 6 weeks before returning to most activities), and a post-surgical orthodontic phase (6 to 12 months to fine-tune the bite). Full resolution of swelling and the final facial result may take up to 12 months from the date of surgery. ### What is orthognathic surgery? Orthognathic surgery is surgical repositioning of the upper jaw (maxilla), lower jaw (mandible), or both, to correct significant jaw discrepancies that cannot be adequately treated by orthodontic tooth movement alone. It is performed by a maxillofacial surgeon under general anaesthetic, with all incisions made inside the mouth (no external scarring). The jaws are repositioned and held in place with titanium plates and screws. The surgery is always combined with orthodontic treatment before and after the procedure — it is not a standalone treatment. ### Who needs jaw surgery alongside braces? Jaw surgery is needed when a patient has a significant skeletal discrepancy — a difference in the size or position of the upper and lower jaws — that cannot be corrected by moving teeth alone. Common indications include a severe underbite or large overjet caused by jaw size difference rather than just tooth position, a skeletal open bite, significant facial asymmetry, and some cases of obstructive sleep apnoea. The decision is made by an orthodontist and maxillofacial surgeon working together, based on clinical assessment, X-rays, and 3D scans. ### Is jaw surgery available on the NHS in the UK? Yes — orthognathic surgery is one of the few adult orthodontic treatments available on the NHS in the UK. It is funded when the jaw discrepancy causes or is likely to cause functional problems (difficulties with biting, chewing, speech, or breathing) and when the clinical severity warrants surgery. Access is through referral from a GDP to an NHS specialist orthodontist, who coordinates with a maxillofacial surgery service. Waiting times for NHS orthognathic treatment vary by region and can be significant in some areas. ### How long does orthognathic surgery treatment take in total? The full orthognathic treatment process typically takes 18 to 30 months from start to finish. This includes a pre-surgical orthodontic phase (usually 12 to 18 months of fixed braces before surgery), the surgery itself (1 to 3 nights in hospital), recovery (2 to 6 weeks before returning to most activities), and a post-surgical orthodontic phase (6 to 12 months to fine-tune the bite). Full resolution of swelling and the final facial result may take up to 12 months from the date of surgery. ## References - British Orthodontic Society — Orthognathic surgery: patient information (https://www.bos.org.uk/patients/orthodontic-appliances/orthognathic-surgery) - BOS patient information on orthognathic (jaw) surgery, covering the clinical indications for combined orthodontic and surgical treatment, the treatment process from pre-surgical orthodontics through surgery and post-surgical refinement, what patients can expect during recovery, and the NHS pathway for accessing orthognathic treatment in the UK. - British Association of Oral and Maxillofacial Surgeons — Orthognathic surgery: patient guide (https://www.baoms.org.uk/patients/orthognathic_surgery/) - BAOMS patient guide on orthognathic (corrective jaw) surgery, including the types of jaw discrepancy treated surgically, the combined orthodontic and surgical treatment pathway, what happens during surgery, the expected recovery timeline, the risks and complications of orthognathic procedures, and guidance on NHS versus private access. - Journal of Oral and Maxillofacial Surgery — Patient satisfaction and quality of life outcomes following orthognathic surgery (https://www.joms.org/) - Research on patient-reported outcomes and quality of life measures following orthognathic surgery, covering functional improvements in chewing, breathing, and speech, aesthetic satisfaction with facial changes, psychological wellbeing outcomes, and the proportion of patients who report the treatment as having significantly improved their quality of life. - British Orthodontic Society — Orthognathic surgery: patient information (https://www.bos.org.uk/patients/orthodontic-appliances/orthognathic-surgery) - BOS patient information on orthognathic (jaw) surgery, covering the clinical indications for combined orthodontic and surgical treatment, the treatment process from pre-surgical orthodontics through surgery and post-surgical refinement, what patients can expect during recovery, and the NHS pathway for accessing orthognathic treatment in the UK. - British Association of Oral and Maxillofacial Surgeons — Orthognathic surgery: patient guide (https://www.baoms.org.uk/patients/orthognathic_surgery/) - BAOMS patient guide on orthognathic (corrective jaw) surgery, including the types of jaw discrepancy treated surgically, the combined orthodontic and surgical treatment pathway, what happens during surgery, the expected recovery timeline, the risks and complications of orthognathic procedures, and guidance on NHS versus private access. - Journal of Oral and Maxillofacial Surgery — Patient satisfaction and quality of life outcomes following orthognathic surgery (https://www.joms.org/) - Research on patient-reported outcomes and quality of life measures following orthognathic surgery, covering functional improvements in chewing, breathing, and speech, aesthetic satisfaction with facial changes, psychological wellbeing outcomes, and the proportion of patients who report the treatment as having significantly improved their quality of life.