Double jaw surgery is used throughout the world to reconstruct significant facial deformities. More unique to East Asia and particularly South Korea is the increasingly aggressive application of these extreme and expensive techniques to address relatively minor cosmetic concerns during elective facial reshaping. So what exactly is double jaw surgery?
There are two jaw bones: the upper jaw bone, or maxilla, and the lower jaw bone, or mandible. The two bones are hinged and so work together as a pair when performing many important functions (biting, chewing, speech, and so on). Each bone houses a row of teeth. The top portion of the maxilla forms the mid-face surrounding the nose and extending to the eye sockets, while the bottom or most forward-portion of the mandible becomes the chin. The bones are surrounded by soft tissue: the skin and fat of the mouth and cheeks, the lips, the bottom of the nose on the outside, and the gums, tongue and, throat on the inside.
Congenital or developmental growth issues in these highly interconnected areas on the face often involve both jaw bones. The teeth and soft tissues surrounding the bones reflect such bony variations. Not surprisingly, surgery to alter appearance or function on the mid and lower face may require working on both jaw bones to achieve the most complete result, hence the name "double jaw surgery."
Surgery on the jaw bones (orthognathic surgery) is a complex subject and frequently outside the scope of training and experience of most plastic surgeons. For this reason, anything more than simple operations on the jaw are usually performed by dental specialists known as "maxillofacial surgeons." In essence, the bones are broken, reshaped if needed, and then reassembled with metal plates, screws, and wires. Sometimes bone grafting is also employed.
Depending on the issues of concern in each particular patient, the upper and/or lower jaw bones may be moved forward, moved backwards, or reduced or increased in size relative to the another. The overlying soft tissues can then change their position for the better, often with little or no direct incisions, tissue removal, or visible scarring (the incisions are usually placed inside the mouth).
For instance, if the maxilla (upper jaw bone) is not well developed and their is a bad underbite it may be more effective to move both the maxilla forward and the mandible backward than trying to achieve an impossibly large movement of only the maxilla.
Common applications of this surgery in the Asian population include operations to address jutting lower jaw (mandibular prognathism), long face syndrome, facial asymmetry, sunken cheeks, a protruding mouth, the under or over developed chin, a gummy smile, and various dental misalignments.
Healing is a long process. Facial swelling can be severe after surgery, and the mouth is often wired shut. Numbness is common but usually disappears. Braces may be needed for several years. Recovery to relative normalcy can take at least two months but sometimes much longer.
Serious complications following double jaw surgery such as infection, poor healing, permanent numbness, unexpected deformity, and rarely death can and do occur, especially when these specialized operations are attempted by surgeons with insufficient training and experience.