Orthognathic Surgery

What is Orthognathic Surgery?

Orthognathic surgery refers to surgical moving or repositioning one or both jawbones to a new position. 

The Purpose of Orthognathic/Jaw Surgery:

  • Improve facial cosmetics
  • Correct malocclusion (your bite is off)
  • Open your airway – make your breathing better
  • Correct sleep apnea
  • Align your teeth for corrective dentistry 

A very tolerable procedure

  •  Done as an outpatient in our surgical suite vs. a hospital environment – no added hospital fees

Affordable – combine your insurance benefits and payment plans

  • We have in-office financing
  • Medical insurance may cover a part of your procedure
  • Dental insurance may cover part of third molar removal

 Surgical Facts:

  • Done from inside your mouth – no outside incisions
  • You can open and close your mouth when you wake up
  • Done as an in-office outpatient procedure
  • Diet is soft foods for 6 weeks
  • Minimal post-op pain
  • Significant facial swelling for about 10-14 days
  • Typically, 7-8 days off work or school

Am I a candidate for Orthognathic Surgery?

People are candidates for the following reasons:

    1. Dental Malocclusion:

  • Your teeth cannot be aligned by braces alone – your bite is too far off.
  • Lining up the jawbone – either the upper, lower or both – will line up your teeth in a healthy and stable way. 

    2. Facial Cosmetics:

  • People with gummy smiles, short or too long of a chin, narrow smiles and faces are candidates.
  • A short chin can be greatly enhanced by bringing the chin forward, but also bringing both the upper and lower jaws forward and rotating them in a way to provide a very significant improvement in the projection of your chin and face. 
  • Also – many people do not show their teeth, and this can be corrected as well. 

3. Poor Airway causing sleep and breathing issues.

Orthognathic surgery is the only surgical procedure that can improve the airway significantly and not require patient compliance afterwards. 

Jaw surgery brings the jawbones forward, and pharyngeal tissues of the airway – very successfully mechanically opening up the airways. 

Most of our patients undergoing this surgery can eliminate their CPAP usage, report significant improved cognitive function, improved cardiovascular function.  Research also reports decreased risks of developing many age-related diseases such as dementia, diabetes, and erectile dysfunction (ED)

People who can benefit from orthognathic surgery include those with an improper bite, or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that may affect chewing function, speech, or long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required for the jaws when repositioning is necessary.

The Process:

  1. Initial Consultation

We evaluate you, determine your needs and necessary treatment.  Recommend an orthodontist if needed. Review fees and avenues of payment (see global fee structure below)

   2. Pre-surgical appointment

A review of the procedures with yourself and family member.  Digital records of your teeth (via intra-oral scan) updated radiographs and photos to utilized for surgical treatment planning and splint fabrication.

   3. Surgery appointment

In our surgery center. 

   4. Post-operative follow-ups.

1 week, 3 weeks, and 6-week follow-up.  Typically, one or two more at 3 months and when orthodontics is completed is utilized. 

Orthodontics and Orthognathic Surgery

Are braces required? 

In most instances orthodontics are utilized to refine the occlusion.  We can line up the bones but in their new positions the teeth now line up differently and therefore need to be adjusted to fit the new spatial alignment of the jaw bones.

Typically, you have braces placed first for several months for what is called pre surgical orthodontics. This removes many of the positional compensations your teeth have gone through due to the malalignment of your jaw bones.  Once surgery lines up your bones – the position of your teeth is finalized via post-surgical orthodontics.

Invisalign – also known as retainer therapy. Our orthognathic procedures can be done in conjunction with Invisalign therapy. We just must place temporary appliances on during your surgery – and remove them prior to you waking up. This is so we can accurately set your bite prior to our procedure.

On occasion – people present with very nicely aligned teeth prior to their surgery.  These are people having the procedure done for cosmetic reasons or to open their airway up to improve their breathing for sleep.  In these cases – orthodontics can be eliminated.  However – some of these people need post-surgical orthodontics or Invisalign – to post-surgical fine tune the bite. 

 Difficulty in the following areas should be evaluated:

  • Difficulty in chewing, biting, or swallowing
  • Speech problems
  • Chronic jaw or TMJ pain
  • Open bite
  • Protruding jaw
  • Breathing problems

How long does it take to recover from Orthognathic Surgery? 

Technology & Orthognathic Surgery

Dr. Loetscher uses modern computer-aided techniques and three-dimensional models to show you exactly how your surgery will be approached. Using comprehensive facial x-rays and computer video imaging, we can show you how your bite will be improved and even give you an idea of how you’ll look after surgery. This helps you understand the surgical process and the extent of the proposed treatment.

If you are a candidate for corrective jaw surgery, Dr. Loetscher will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.
Corrective jaw surgery is a significant intervention requiring many months of preparation. The surgery is performed in our office. Braces are maintained during surgery and may need to be removed six-to-twelve months after surgery. The greatest impact of orthognathic surgery is the recovery phase. Patients typically may be off work/school from two weeks-to-one month after surgery. Return to normal chewing function may take 2 months and full function may take one year. Our goal is to ensure you are well taken care of during and after surgery. Weekly appointments are required for up to two months after surgery.

View our Jaw Surgery Gallery

Cost of Orthognathic Surgery

Dr. Loetscher does the majority of orthognathic surgery in his outpatient surgery facility. This provides a clean, controlled environment as well as a major cost savings to our patients by eliminating the hospital and associated fees.

There are several factors going into the cost of Orthognathic Surgery:

  1. Pre- and Post-operative orthodontics. Orthognathic surgery is done in conjunction with orthodontics. Orthodontic fees in the area run approximately $5,000 – $6,500
  2. The surgery itself (see below)
  3. The time off of school or work 7-14 days
  4. Insurance Coverage: About 70% of our patients have insurance that cover some of the costs of the surgery. The Surgical fee itself:

Global Orthognathic Surgery Fees January 2022

We have established “Global Fees” for our Orthognathic Surgery patients. The global fees cover the surgeons fee, anesthesiologist’s fee, and all surgery center fees, including pre-op appointments and follow-up appointments for the first year.

Lower Jaw (BSSO)
$16,700
Upper Jaw (1 or 2 piece LeFort)*
$17,700
Genioplasty (Advancement)
Set Back 
$4,900
$6,200
Upper Jaw & Chin or Lower Jaw & Chin
$19,700
Upper & Lower Jaw Together
$32,400
Upper & Lower Jaw, with Chin
$34,400
Surgical Rapid Palatal Expansion (RPE)
-including Anesthesia
$5,800
Surgical Rapid Expansion – Lower Jaw
-including Anesthesia
$3,700
Post-Operative In-Home Nursing Service
$100 – $300

Note:  Surcharge for a 3 piece maxilla upper jaw modification for severe open-bite closure is an additional $2,200.

These fees represent the combined collection from the patient and their insurance company. We require a deposit to schedule. Most insurance carriers will not disclose amounts they will pay for the procedure until it has been performed. Pending insurance approval – your amount paid prior to your surgery may be decreased – depending upon your insurance.

We will file to your insurance for reimbursement of all reasonable items, including the surgeon and anesthesiologist’s fee, and supplies. This will be reimbursed upon receipt.

  • Post-operative in-home Nursing services:    $100-$200

Financing:

CareCredit is available with our office for financing.

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