Vous êtes au centre: Votre Expérience, Vos Résultats.
It's About You: Your Experience, Your Results.

Jaw Surgery



Malocclusions can be so severe as to involve not only the dentition but also the supporting jawbones, causing a dentofacial deformity. Correction of such malocclusions is most stable when utilizing a combination of dentistry, orthodontics and orthognathic (jaw) surgery. Unbalanced facial proportions and profiles are accounted for in your overall treatment plan to optimize masticatory function, arthrokinetic/TMJ function and facial esthetics.

TMJ and Orthognathic Surgery:
Many dentofacial or dentoskeletal malocclusions are caused by a TMJ pathology that may require treatment prior, simultaneously or after orthognathic surgery. These TMJ pathologies causing facial asymmetries and malocclusions include degenerative joint disease (severe arthritis), progressive/idiopathic condylar resorption, condylar hyperplasia and a benign condylar tumor.

Sleep Apnea and Orthognathic Surgery:
Bimaxillary (upper and lower jaw) advancement is an excellent surgical option to reduce the effects of severe obstructive sleep apnea (OSA), and is reserved for those who fail to improve with or cannot tolerate a continuous positive airway pressure (CPAP) machine.



UPPER AND LOWER JAW SURGERY: Pre-operative instructions and Post-operative instructions

UPPER JAW SURGERY ONLY: Pre-operative instructions and Post-operative instructions

LOWER JAW SURGERY ONLY: Pre-operative instructions and Post-operative instructions


UPPER AND LOWER JAW SURGERY
The following information pertains to patients scheduled to undergo a Le Fort I osteotomy (upper jaw or maxilla) and bilateral sagittal split osteotomies (lower jaw or mandible).

Prior to Surgery:
1. Ensure that you have scheduled both a pre-surgical work-up appointment and a pre-surgical discussion appointment at our Natix clinic with our orthognathic surgery coordinator (Dr. Veronika Leon).
2. There is no need for your caregiver to be present at the work-up appointment, however, your caregiver and you must be present at the discussion appointment. Details pertaining to your specific case will be reviewed.
3. All double jaw surgeries are planned in-house by your surgeon, using the Dolphin Virtual Surgical Planning software, with the utmost digital precision available.
4. You will be given prescriptions, your surgeon’s personal number and a jaw bra and ice packs for your immediate postop comfort.
5. The hospital staff at the admission’s office will contact you for your pre-operative tests and they will also advise you of the time and place to show up on the day of your surgery.
6. You must see your orthodontist several days prior to surgery so that surgical hooks can be installed on your orthodontic wires. Special instructions will be provided to Invisalign surgical patients.
7. You must be fasting as of midnight the night before your operation.
8. For their safety, women taking oral contraceptive medications must stop these 1 month prior to the surgical date to avoid dangerous blood clots, otherwise the operation will be rescheduled.
9. Men must be clean-shaven for both the work-up appointment and surgery. Women must avoid facial make-up and all nail treatments. All piercings should be removed. Hair should be shampooed the night prior to surgery.

Day of Surgery:
1. This surgery is usually done in a hospital or surgicenter operating room (OR), under general anesthesia.
2. Patients will meet the anesthetist and Nursing team prior to entering the OR.
3. The surgical time usually varies between 2.5h to 4.5h, depending on the complexity of the case.
4. As you wake up from general anesthesia, you will not be able to open your mouth widely. There will be elastics guiding your lower teeth into your new bite, and a head bandage keeping the swelling to a minimum.
5. You will then be observed for some time in the Post-Anesthesia Care Unit (PACU), prior to transfer to your room. Patients at risk of sleep apnea will be observed in the Intensive Care Unit (ICU) for at least one post-operative night.


After Surgery:
1. Following double jaw surgery, most patients stay 2 nights at the hospital.
2. You can expect nasal and sinus congestion, fatigue, mild to moderate pain, significant swelling of the face and lips, bleeding from the nose and mouth, and a sore throat when trying to swallow for the first 5 days.
3. Your diet is clear liquids for the first 48 hours. You are encouraged to sip on water, clear juices or ice chips throughout the day. As of the 3rd day, your diet can progress to thick liquids and to purees until the 14th post-operative day. You will likely be on a soft solid diet by the beginning of the 3rd week. We encourage you to purchase a nutritional support and immune-modulating package by creating an account at natix.metagenicscanada.com, and select the bundle "Chirurgie Ortho - Jaw Surgery." Use the promotional code 10OFFNATIX for a 10% discount.
4. It is imperative to rinse your mouth with saline or salt water 5x/day for the first 2 weeks. As of the first postoperative day, you must brush your teeth, braces and elastics, as far back as you can reach, with a small amount of toothpaste and a child size toothbrush.
5. Guiding elastics placed during the surgery will be changed at your one-week follow up visit at our Natix clinic.
6. You can expect a 50% reduction in facial swelling after one week, and an 80% reduction in facial swelling at 2 weeks.
7. If you are scheduled to have a segmental Le Fort I osteotomy (2 or 3 upper jaw segments), the final surgical guide or splint will be removed in the clinic at 4 weeks after surgery. It is imperative that you have an upper orthodontic wire change, scheduled at your orthodontist, on the same day after this appointment.
8. Thankfully, the pain level is mild to moderate since your facial sensory nerves will not be fully functional. The sensation of your lips, chin, nose, lower eyelids and gums usually starts to return at 14 days after surgery. The return of feeling peaks at 3 to 4 months, but can take over 1 year to fully recover. Note that there is a 20% chance of permanent reduction in the sensation of your lower lip and chin when undergoing bilateral sagittal split osteotomies, however this will not cause permanent speaking or eating dysfunction.




UPPER JAW SURGERY ONLY
The following information pertains to patients scheduled to undergo a Le Fort I osteotomy only (upper jaw or maxilla).

Prior to Surgery:
1. Ensure that you have scheduled both a pre-surgical work-up appointment and a pre-surgical discussion appointment at our Natix clinic with our orthognathic surgery coordinator (Dr. Veronika Leon).
2. There is no need for your caregiver to be present at the work-up appointment, however, your caregiver and you must be present at the discussion appointment. Details pertaining to your specific case will be reviewed.
3. All double jaw surgeries are planned in-house by your surgeon, using the Dolphin Virtual Surgical Planning software, with the utmost digital precision available.
4. You will be given prescriptions, your surgeon’s personal number and a jaw bra and ice packs for your immediate postop comfort.
5. The hospital staff at the admission’s office will contact you for your pre-operative tests and they will also advise you of the time and place to show up on the day of your surgery.
6. You must see your orthodontist several days prior to surgery so that surgical hooks can be installed on your orthodontic wires. Special instructions will be provided to Invisalign surgical patients.
7. You must be fasting as of midnight the night before your operation.
8. For their safety, women taking oral contraceptive medications must stop these 1 month prior to the surgical date to avoid dangerous blood clots, otherwise the operation will be rescheduled.
9. Men must be clean-shaven for both the work-up appointment and surgery. Women must avoid facial make-up and all nail treatments. All piercings should be removed. Hair should be shampooed the night prior to surgery.

Day of Surgery:
1. This surgery is usually done in a hospital or surgicenter operating room (OR), under general anesthesia.
2. Patients will meet the anesthetist and Nursing team prior to entering the OR.
3. The surgical time is about 2h, depending on the complexity of the case.
4. As you wake up from general anesthesia, you will not be able to open your mouth widely. There may be elastics guiding your lower teeth into your new bite, and a head bandage keeping the swelling to a minimum.
5. You will then be observed for some time in the Post-Anesthesia Care Unit (PACU), prior to transfer to your room. Patients at risk of sleep apnea will be observed in the Intensive Care Unit (ICU) for at least one post-operative night.

After Surgery:
1. Following upper jaw surgery, most patients stay 1 night at the hospital; others can be discharged home that evening. Your surgeon will advise you accordingly.
2. You can expect nasal and sinus congestion, fatigue, mild to moderate pain, significant swelling of the face and lips, bleeding from the nose and mouth, and a sore throat when trying to swallow for the first 5 days.
3. Your diet will be clear liquids for the first 24 hours. You are encouraged to sip on water, juices or ice chips throughout the day. As of the 2nd day, your diet can progress to thick liquids and to purees until the 10th post-operative day. You will likely be on a soft solid diet by the beginning of the 11th day. We encourage you to purchase a nutritional support and immune-modulating package by creating an account at natix.metagenicscanada.com, and select the bundle "Chirurgie Ortho - Jaw Surgery." Use the promotional code 10OFFNATIX for a 10% discount.
4. It is imperative to rinse your mouth with saline or salt water 5x/day for the first 2 weeks. As of the first postoperative day, you must brush your teeth, braces and elastics, as far back as you can reach, with a small amount of toothpaste and a child size toothbrush.
5. If guiding elastics are placed during the surgery, these will be changed at your one-week follow up visit at our Natix clinic.
6. You can expect a 50% reduction in facial swelling after one week, and an 80% reduction in facial swelling at 2 weeks.
7. If you are scheduled to have a segmental Le Fort I osteotomy (2 or 3 upper jaw segments), the final surgical guide or splint will be removed in the clinic at 4 weeks after surgery. It is imperative that you have an upper orthodontic wire change, scheduled at your orthodontist, on the same day after this appointment.
8. Thankfully, the pain level is mild to moderate since your facial sensory nerves will not be fully functional. The sensation of your upper lip, nose, lower eyelids and gums usually starts to return at 14 days after surgery. The return of feeling peaks at 3 to 4 months, but can take over 1 year to fully recover.



LOWER JAW SURGERY ONLY
The following information pertains to patients scheduled to undergo bilateral sagittal split osteotomies only (lower jaw or mandible).

Prior to Surgery:
1. Ensure that you have scheduled both a pre-surgical work-up appointment and a pre-surgical discussion appointment at our Natix clinic with our orthognathic surgery coordinator (Dr. Veronika Leon).
2. There is no need for your caregiver to be present at the work-up appointment, however, your caregiver and you must be present at the discussion appointment. Details pertaining to your specific case will be reviewed.
3. All lower jaw surgeries are planned in-house by your surgeon, using the Dolphin Virtual Surgical Planning software, with the utmost digital precision available.
4. You will be given prescriptions, your surgeon’s personal number and a jaw bra with ice packs for your immediate postop comfort.
5. The hospital staff at the admission’s office will contact you for your pre-operative tests and they will also advise you of the time and place to show up on the day of your surgery.
6. You must see your orthodontist several days prior to surgery so that surgical hooks can be installed on your orthodontic wires. Special instructions will be provided to Invisalign surgical patients.
7. You must be fasting as of midnight the night before your operation.
8. For their safety, women taking oral contraceptive medications must stop these 1 month prior to the surgical date to avoid dangerous blood clots, otherwise the operation will be rescheduled.
9. Men must be clean-shaven for both the work-up appointment and surgery. Women must avoid facial make-up and all nail treatments. All piercings should be removed. Hair should be shampooed the night prior to surgery.

Day of Surgery:
1. This surgery is usually done in a hospital or surgicenter operating room (OR), under general anesthesia.
2. Patients will meet the anesthetist and Nursing team prior to entering the OR.
3. The surgical time usually varies between 1.5h to 2h, depending on the complexity of the case.
4. As you wake up from general anesthesia, you will not be able to open your mouth widely. There will be elastics guiding your lower teeth into your new bite, and a head bandage keeping the swelling to a minimum.
5. You will then be observed for some time in the Post-Anesthesia Care Unit (PACU), prior to transfer to your room. Patients at risk of sleep apnea will be observed in the Intensive Care Unit (ICU) for at least one post-operative night.

After Surgery:
1. Following lower jaw surgery, most patients stay 1 night at the hospital; others can be discharged home that evening. Your surgeon will advise you accordingly.
2. You can expect nasal and sinus congestion, fatigue, mild to moderate pain, significant swelling of the face and lips, bleeding from the nose and mouth, and a sore throat when trying to swallow for the first 5 days.
3. Your diet is clear liquids for the first 48 hours. You are encouraged to sip on water, clear juices or ice chips throughout the day. As of the 3rd day, your diet can progress to thick liquids and to purees until the 14th post-operative day. You will likely be on a soft solid diet by the beginning of the 3rd week. We encourage you to purchase a nutritional support and immune-modulating package by creating an account at natix.metagenicscanada.com, and select the bundle "Chirurgie Ortho - Jaw Surgery." Use the promotional code 10OFFNATIX for a 10% discount.
4. It is imperative to rinse your mouth with saline or salt water 5x/day for the first 2 weeks. As of the first postoperative day, you must brush your teeth, braces and elastics, as far back as you can reach, with a small amount of toothpaste and a child size toothbrush.
5. Guiding elastics placed during the surgery will be changed at your one-week follow up visit at our Natix clinic.
6. You can expect a 50% reduction in facial swelling after one week, and an 80% reduction in facial swelling at 2 weeks.
7. Thankfully, the pain level is mild to moderate since your facial sensory nerves will not be fully functional. The sensation of your lips, chin, nose, lower eyelids and gums usually starts to return at 14 days after surgery. The return of feeling peaks at 3 to 4 months, but can take over 1 year to fully recover. Note that there is a 20% chance of permanent reduction in the sensation of your lower lip and chin when undergoing bilateral sagittal split osteotomies, however this will not cause permanent speaking or eating dysfunction.
8. If you are scheduled to have a segmental mandibular osteotomy (2 lower jaw segments), the final surgical guide or splint will be removed in the clinic at 4 weeks after surgery. It is imperative that you have a lower orthodontic wire change, scheduled at your orthodontist, on the same day after this appointment.