In Which Cases Is Orthognathic Surgery Necessary?
When you observe people in the crowds of Istanbul, on the subway, or on the streets, you notice a “disharmony” in some people’s faces. Some have a very prominent lower jaw and a harsh expression; some have a very receding jaw and a “bird face” appearance. Some have excessively visible gums when they smile. Most people think this is just an “aesthetic flaw” or a “gift from God.” However, this condition is called “Skeletal Jaw Disorder” in medicine.
These disorders don’t just affect outward appearance; they are serious health problems that disrupt eating, speaking, breathing, and even sleep quality. This is where orthodontic surgery comes into play, where the jaws are surgically cut and repositioned, as orthodontic braces are insufficient. What is Orthognathic Surgery? “Correction,” Not “Masking”
Many patients believe they can correct the misalignment of their teeth with braces. If the problem is only the alignment of the teeth, then yes, braces are sufficient. However, if the problem is the position of the jawbones (skeletal), braces only correct the teeth but not the jaw. This is called “Camouflage Treatment.”
Orthognathic surgery, on the other hand, solves the problem at its root. Under general anesthesia, the upper jaw (maxilla) and lower jaw (mandible) are cut in a controlled manner by the surgeon, brought to the ideal position, and fixed with titanium plates. This is the reconstruction of the facial skeletal structure.
Which Conditions Make Surgery “Mandatory”?
The 6 main conditions that lead to the decision for surgery in our patients who apply to clinics in Istanbul are as follows:
- 1. Prognathism (Class 3)
The lower jaw is significantly ahead of the upper jaw. There is a “crescent” appearance in the face. These patients cannot bite with their front teeth (they cannot eat a sandwich). Chewing only occurs with the back teeth, which leads to joint pain. - 2. Retrognathism (Class 2)
The lower jaw is very far back. In profile, the chin is indistinct, and the nose appears larger than it is (“Bird Face”). The biggest danger is Sleep Apnea. The tongue root falls back and obstructs the airway. - 3. Open Bite
When the patient clenches their back teeth, their front teeth do not touch, leaving a gap. A lisp occurs during speech, breathing is done through the mouth, and there is no biting function.
4. Facial Asymmetry
The chin is shifted to the right or left. One side of the face appears longer or more prominent than the other. This is detrimental both aesthetically and for the temporomandibular joint (TMJ). 5. Gummy Smile
The upper jaw is excessively elongated vertically (Long Face). When smiling, more than 4-5 mm of the gums are visible. The lips do not close at rest; the patient struggles to close their mouth.
⚠️ Sleep Apnea and Jaw Surgery
A large percentage of patients experiencing snoring and sleep apnea have “Mandibular Retrusion”. The airway is anatomically narrow. For patients who do not want to use a CPAP device (mask), the most permanent solution is orthognathic surgery, where the upper and lower jaws are brought forward (Maxillomandibular Advancement). This procedure widens the airway, saving the patient from suffocation.
Comparison: Orthodontics Only or Surgery?
Differences between “Camouflage Treatment” and “Surgical Solution” for undecided patients:
| Criteria | Orthodontics Only (Braces) | Orthodontics + Orthognathic Surgery |
|---|---|---|
| Area of Effect | Straightens only the teeth. | Straightens both the teeth and the bones. |
| Facial Aesthetics | Changes in profile (face shape) It does not. | Changes facial profile and proportions by 100%. |
| Airway | Has no effect on breathing. | Opens the airway, improves breathing. |
| Duration | 1.5 – 2 Years. | 1.5 – 2 Years (Surgery is performed in the middle of the treatment). |
| Result | Skeletal problem is hidden (masked). | Skeletal problem is permanently resolved. |
📍 Istanbul: Surgical Excellence in Health Tourism
Orthognathic surgery is a team effort (Orthodontist + Oral Surgeon). Istanbul is one of the centers where these two disciplines are best coordinated. These surgeries, which are delayed for years in Europe or America due to insurance procedures and waiting lists, are performed in Istanbul with the latest technology (3D Planning, Piezo Surgery) andIt is performed much more accessibly and quickly with experienced teams. Patients who come with the slogan “A new face, a new life” leave Istanbul with renewed self-confidence.
Surgery Age: When Should It Be Done?
Since this surgery involves the bones, completion of growth and development is essential.
- For girls: Usually after 17-18 years old.
- For boys: Usually after 18-20 years old.
However, in cases of “breathing only” or very severe anomalies, special surgeries can be performed while growth continues. There is no upper age limit; a 50-year-old individual with good bone health can also have this surgery.
How Does the Process Work?
This is not a “magic wand” operation, it is a process:
- Orthodontic Treatment (Pre-Surgery): The teeth are aligned properly according to the jaws. At this stage, your teeth may temporarily look worse (decompensation), this is normal.
- Surgery: It is usually done under general anesthesia, through the mouth (no scar remains on the face). You will stay in the hospital for 2-3 days.
- Recovery: Swelling will occur for the first week. The jaws may remain connected with elastics. Liquid feeding is done.
- Wire Treatment (Post-Surgery): Wires remain in place for another 6 months for detailed closure adjustments and are then removed.
🎨 “Profiloplasty” Effect
Orthognathic surgery is actually one of the most effective plastic surgery operations. When the jaws are in the correct position; the tip of the nose lifts, the cheekbones become more prominent, the double chin disappears, and lip fullness increases. The patient gains not only the ability to chew but also a face with the “Golden Ratio”.
Result: A Challenging But Valuable Journey
Orthognathic surgery is not a simple procedure that can be done with a “I’ll just go and get it done” attitude. It requires material and emotional preparation, patience, and time. However, in terms of results, it is one of the surgeries with the highest patient satisfaction rate.
For someone who has lived for years estranged from their reflection in the mirror, unable to bite into a sandwich or get enough sleep, this surgery means starting life anew. Our expert team in Istanbul is ready to guide you on this transformation journey, achieving a perfect balance of function and aesthetics.
