Jaw Surgery / Orthognathic Surgery

These terms are all synonyms for surgery that involves the moving of the upper (MAXILLA)and lower (MANDIBLE) jaws to provide better facial balance and better occlusion (bite.) In addition, cleft lip and palate surgery needs attention to the soft tissues of the lip and palate. The benefits may include improvement in the bite, chewing (mastication), facial pain, jaw function, and or breathing. It is not possible to separate out the functional and esthetic benefits of the procedures. Many patients improve their overall facial appearance as well.

Here you can find:

General description

The jaws may be moved forward, backward and sideways. The surgeries are typically performed within your mouth so the scars are hidden from view. Titanium metal plates and screws are used to hold the jaws in the new positions. These metallic appliances remain embedded under the muscles and are rarely removed. They do not set off the alarm detectors at the hospital.

Severe jaw deformities typically associated with cleft lip and palate may require special techniques such as Distraction Osteogenesis. This technique involves the slow stretching of the bone and scar tissue using special appliances. Dr. Heffez has done extensive research on this technique and published his findings in the Journal of Oral and Maxillofacial Surgery. Prior to the advent of this technique patients used to have to accept less than satisfactory results. Today, the results are unparalleled.

As Former Professor for 30 years, Department Head for over 16 years, Program Director Oral and Maxillofacial Surgery and Consultant to the Craniofacial Center at the University of Illinois at Chicago, Dr. Heffez has had the unique opportunity to teach other surgeons, residents and students in the surgical techniques he mastered over his careers.

Today, his expertise brings him to international grounds where he teaches teams of surgeons to perform such operations. He has traveled to all parts of the globe including China, India, Israel, Mexico, Palestinian Territories, and Turkey.
Scroll down for FAQ.

FAQ

Is the surgery PAINFUL?

NO. Most patients are managed with intravenous forms of ibuprofen type drugs and occasionally a low level narcotic like codeine.

Typically a lower jaw surgery or chin surgery is performed as an outpatient.

The upper jaw requires an overnight stay to monitor for bleeding and nay breathing difficulties. The upper jaw surgery involves separating the sinuses and inner bones of the nose. You are given special medicine to help the blood clots shrink and allow you to breathe easier.

If you will surgery to correct both jaws you will likely be in the hospital 2 days (the day of surgery, the day after surgery and the next morning you go home.)

Dr. Heffez provides his email and cell number to all patients and family members for quick access.

First, Dr. Heffez will tell you your diagnosis that is, where your problems lie and what will be corrected with surgery. He will go through the risks versus benefits of the procedures and alternative procedures if any (INFORMED CONSENT).

You will go to the hospital where you will be introduced to the nursing and anesthesiology staff. The Anesthesiologist is the doctor responsible for putting you asleep during the procedure. You will have an IV placed through some medication to relax you might be given.

Then, you will go to the operating room where you will be put to asleep. When you are asleep there are certain things that will happen to you which you only become aware of when you awaken.

The anesthesiologist will put a tube down your nose for you to breathe. Upon awakening, he or she will remove the tube when you are fully awake. This does not hurt. Rarely, if you are very sleepy, the tube will stay in overnight.

When you are sleeping, the nurse will place a catheter in you to monitor how much urine you are making. In long case (TWO-JAW PROCEDURES) the catheter will remain in overnight. Otherwise, it will be removed when you are sleeping. In the event that its is removed the next day, it is NOT Painful to do and actually almost slips out.

Your jaw may be closed shut with elastics in some cases. Dr. Heffez will discuss this possibility with you before surgery. In some cases, it is only for a week or two and in other cases 6 weeks.

Jaws are typically closed down with elastics/rubber bands not wires fro a sort period of time depending on your problem (1-2 weeks). In this way , the elastics can easily be cut with manicure scissors in the case of severe vomiting or nausea. This period allows for the teeth to settle into a better bite and speeds up orthodontic treatment.

The jaws are typically not elasticed/rubber banded or wired shut and you are able to open and close after surgery.

Just call Dr. Heffez. He will provide you his cell number in case of emergency.

A waiting period of 3 months is best to wait for the bones to heal adequately.

Below you can find a DIET INSTRUCTION BOOK. Be inventive with your liquid non-chewing diet. A blender is a must. Remember, even spaghetti and meatballs can go in a blender. You’ll get used to it. But eggs, soft fish, puddings, thick soups are all acceptable.

You are typically seen once a week for the first 6 weeks. Thereafter, every 2 weeks to a month for two months. Then, you are seen every 6 months for 2 years. These are an approximate number of visits.

You will be prescribed:

Antibiotic
Anti-inflammatory like ibuprofen
Strong Pain medication like codeine
Ensure Plus or similar Diet Supplement

AND, If you are having upper jaw surgery

Decongestant like Sudafed
Nasal Spray

In some cases,
Iron to boost your blood count

In two-jaw surgery we usually have you donate your blood before surgery. It is rarely used. There are strict rules regarding your ability to donate your blood. You must weigh a certain amount and have a certain blood count to start with. You typically give your donation of one unit 2-3 weeks before surgery in the hospital you will have surgery or at a Life Source.
Blood donation is NOT usually obtained for a single jaw surgery.

This is called a DESIGANTED DONOR. The designated donor is not as good as your own blood. It maybe a close enough match though. That individual will be tested thoroughly by the blood bank at the hospital for at a Life Source.

The surgery is covered with your medical insurance because it is a medical problem. However, each insurance contract is different. We typically send all required materials to your insurance and verify coverage BEFORE surgery takes place, we will then inform you of your deductible, coverage limits and your likely balance.

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