Orthognathic surgery, commonly known as corrective jaw surgery, is an advanced surgical discipline dedicated to repositioning misaligned jaws when standard orthodontics alone cannot resolve severe skeletal discrepancies. While braces straighten teeth within the alveolar bone, orthognathic surgery structurally repositions the underlying maxilla (upper jaw), mandible (lower jaw), or chin to establish an ideal functional bite and restore harmonious facial symmetry. At Oral & Facial Surgery of Miami, board-certified oral and maxillofacial surgeon Dr. Johanny Caceres combines cutting-edge 3D virtual surgical planning with hospital-grade surgical precision in Coral Gables to correct developmental anomalies, alleviate chronic airway collapse, and deliver permanent facial balance.
Clinical Indications and Skeletal Malocclusion Classifications
Jaw discrepancies arise from genetic growth disharmonies, congenital developmental syndromes, or childhood facial trauma. Common skeletal presentations include severe mandibular retrognathia (severe Class II overbite with a retrusive lower jaw and compromised airway), mandibular prognathism (Class III underbite characterized by an extended lower jaw), anterior open bite where front teeth fail to contact, and vertical maxillary excess causing excessive gum display (gummy smile). Patients suffering from skeletal malocclusion frequently experience chronic chewing difficulty, TMJ pain, premature enamel breakdown, speech impediments, and obstructive sleep apnea. When the skeletal discrepancy exceeds what orthodontic tooth movement can safely compensate, orthognathic surgery provides the only definitive anatomical correction.
3D Virtual Surgical Planning and Rigid Internal Fixation
Modern orthognathic surgery has completely eliminated historical guesswork through Virtual Surgical Planning (VSP). Dr. Caceres utilizes high-resolution 3D Cone Beam CT scans and intraoral optical scans to construct an exact digital twin of your skeletal and dental anatomy. Using specialized surgical software, Dr. Caceres simulates osteotomy cuts down to a fraction of a millimeter. For the upper jaw, a Le Fort I osteotomy allows the maxilla to be raised, lowered, or advanced. For the lower jaw, a Bilateral Sagittal Split Osteotomy (BSSO) enables forward or backward repositioning while protecting the inferior alveolar nerve. 3D-printed surgical splints guide intra-operative positioning, and low-profile biocompatible titanium miniplates and screws (rigid internal fixation) secure the bones rigidly, eliminating the need to wire your jaws shut.
| Osteotomy Procedure | Skeletal Movement & Target | Functional & Aesthetic Benefits |
|---|---|---|
| Le Fort I Maxillary Osteotomy | Upper jaw repositioned vertically, horizontally, or widened to match lower arch | Eliminates gummy smiles, closes open bites, and restores midface volume |
| Bilateral Sagittal Split (BSSO) | Lower jaw advanced forward or set backward along the mandibular ramus | Corrects severe overbites or underbites; substantially expands pharyngeal airway |
| Bimaxillary (Double Jaw) Surgery | Simultaneous repositioning of both upper and lower jaws for complex discrepancies | Complete reconstruction of bite relationship, occlusal plane, and facial balance |
| Sliding Genioplasty | Chin bone sectioned horizontally and repositioned in three dimensions | Enhances jawline definition, neck angle, and soft tissue chin projection |
Hospital Surgical Protocols and General Anesthesia Care
Corrective jaw surgery is performed in a fully accredited hospital operating room under general anesthesia administered by board-certified anesthesiologists. Dr. Caceres executes all surgical incisions intraorally through the gums, meaning there are no visible external facial scars. Depending on whether single or double jaw surgery is indicated, the procedure typically takes two to four hours. Thanks to rigid titanium fixation plates, patients are not wired shut after surgery; instead, light guiding elastics help train your chewing muscles into your new bite. Most patients remain overnight in the hospital for observation and IV hydration before being comfortably discharged home the following morning.
Recovery Timeline, Dietary Progression and Long-Term Stability
Post-operative recovery progresses smoothly with disciplined aftercare. Facial swelling and mild bruising peak at day three before steadily resolving over the following two to three weeks. Cold compression wraps and prescribed anti-inflammatory protocols keep discomfort well managed. Patients maintain a full-liquid, high-protein diet for the first two weeks, transitioning to soft non-chew foods (such as scrambled eggs, soft pasta, and mashed potatoes) for weeks three through six. Bone consolidation occurs by six to eight weeks, at which point you return to your orthodontist for final detailing. The structural, functional, and aesthetic benefits of orthognathic surgery are permanent, providing a lifetime of confident chewing, clear breathing, and balanced facial harmony.
Schedule an Orthognathic Surgery Consultation
Correct severe bite misalignment and transform your facial profile. Board-certified oral and maxillofacial surgeon Dr. Johanny Caceres provides advanced 3D orthognathic surgical planning in Coral Gables.