Orthognathic
Surgery
in Dallas–Fort Worth
When jaws don’t meet correctly, orthodontics alone can’t fix it. Orthognathic (corrective jaw) surgery at DFWOMS repositions the upper jaw, lower jaw, or both — correcting your bite, improving function, and transforming your facial profile at our Irving, Mesquite, and Ennis locations.
Correcting the jaw problems orthodontics alone cannot fix
Orthognathic surgery — also called corrective jaw surgery — is a procedure performed by an oral and maxillofacial surgeon to reposition the upper jaw (maxilla), the lower jaw (mandible), or both, in order to correct skeletal discrepancies that affect how your teeth come together and how your face looks and functions.
When a bite problem arises from the position of the jaw bones themselves rather than just the teeth, braces and aligners can align the teeth within each jaw, but they cannot move the jaw bones into a new position. Orthognathic surgery does exactly that — working alongside orthodontic treatment to deliver results that neither discipline can achieve alone. The outcome is a bite that functions correctly, a profile that is more balanced, and in many cases resolution of long-standing functional problems like difficulty chewing, breathing issues, and TMJ pain.
Conditions corrective jaw surgery can address
Jaw growth is a gradual process through childhood and adolescence. In some patients, the upper and lower jaws grow at different rates or in different directions — creating a discrepancy that cannot be corrected without repositioning the bone itself. These conditions may exist from birth, develop due to hereditary patterns, or result from trauma or disease.
Surgical procedures performed at DFWOMS
The specific procedure — or combination of procedures — is determined by the nature and severity of your jaw discrepancy. Our surgeons perform all of the following.
The upper jaw (maxilla) is surgically separated from the facial skeleton and repositioned in three dimensions — it can be moved forward, backward, upward, downward, or rotated to correct its relationship with the lower jaw and the facial profile. This procedure corrects open bites, crossbites, and midface deficiencies, and can also improve lip support and the overall balance of the face. Titanium plates and screws hold the repositioned jaw securely in its new position.
The most common orthognathic procedure. The lower jaw (mandible) is carefully cut on both sides and repositioned forward or backward as needed. This corrects underbites, overbites, and many cases of facial asymmetry. The repositioned jaw is secured with titanium plates and screws. Because both sides of the jaw are moved simultaneously, a single procedure corrects the entire lower jaw and its relationship to the upper.
When both the upper and lower jaws require repositioning, both procedures are performed during the same surgery. This approach is used for complex skeletal discrepancies involving both jaws — including significant open bites, severe underbites, or facial asymmetries affecting both arches. Combining both corrections in a single surgery means one anesthesia event, one recovery period, and a more comprehensive result. It is the most powerful tool available for transforming both the function and aesthetics of the face.
Often performed in combination with upper or lower jaw surgery, genioplasty repositions the chin bone to further refine facial balance. The chin can be advanced, set back, raised, lowered, or shifted laterally — completing the overall facial harmony that jaw surgery alone may not fully achieve. It addresses chin asymmetry, receding chin, or excessive chin projection as part of the comprehensive orthognathic treatment plan.
3D imaging & virtual surgical planning
At DFWOMS, every orthognathic surgery case is planned in three dimensions before the first incision is made. We use state-of-the-art 3D Cone Beam CT imaging combined with virtual surgical planning software to build a precise digital model of your facial skeleton, simulate the planned jaw movements, and design custom surgical guides — all before your surgery date.
Virtual surgical planning allows our surgeons to measure every movement with sub-millimeter precision, evaluate the predicted outcome in three dimensions, identify and resolve potential challenges before the operating room, and communicate the expected result to you clearly using 3D models. Custom surgical splints produced from the virtual plan guide jaw positioning during surgery, significantly improving accuracy and reducing operating time. This technology transforms complex jaw surgery into a predictable, precise procedure.
What to expect, step by step
Your journey begins with a comprehensive consultation with our surgeons, often coordinated with your orthodontist. We perform a complete clinical examination, review X-rays and photographs, and discuss your functional concerns and aesthetic goals. Based on this evaluation, we determine whether orthognathic surgery is indicated and which procedures would best address your specific skeletal discrepancy.
Before surgery, your orthodontist places braces or aligners to align the teeth within each jaw individually. This pre-surgical orthodontic phase — which typically takes 6–18 months — is essential: it ensures that after the jaw bones are repositioned, the teeth will fit together correctly in their new positions. Without this preparation, the bite after surgery would not be stable or functional.
As surgery approaches, a 3D CT scan is taken and uploaded into our virtual planning software. Our surgeons simulate every planned jaw movement on the digital model, verify the predicted outcome, and produce custom surgical splints that will guide jaw positioning in the operating room. This step is what transforms a complex procedure into a precise, reproducible surgical plan.
Surgery is performed under general anesthesia at Baylor University Medical Center, where our surgeons hold full privileges. Incisions are made entirely inside the mouth, leaving no visible external scars. The planned jaw osteotomies are performed, the bones are repositioned precisely according to the virtual plan, and titanium plates and screws secure the new position. Operating time varies from 2–5 hours depending on the procedures performed.
Swelling peaks in the first 3–5 days and resolves gradually over 6–8 weeks. A liquid and soft food diet is maintained for 4–6 weeks. Most patients return to work or school within 2–3 weeks. Opioid-free pain management keeps recovery comfortable. Final results — including full resolution of swelling — are visible at 3–6 months post-operatively.
After healing, your orthodontist resumes treatment to fine-tune the final bite alignment — making the small adjustments that complete the tooth-to-tooth relationship in the new jaw position. This final orthodontic phase typically takes 6–12 months. Together with the surgery, it delivers a result that is both functionally stable and aesthetically refined.
Orthognathic surgery at DFWOMS
Watch how our surgeons use 3D planning and precise surgical technique to transform jaw function and facial harmony.
Expert corrective jaw surgery in Dallas–Fort Worth
Common questions about orthognathic surgery
The key question is whether your bite problem arises from the position of the teeth within the jaw, or from the position of the jaw bones themselves. Orthodontics can correct tooth position; surgery is required when the jaw bones need to be moved. If your orthodontist or dentist has told you that braces alone cannot fully correct your bite, or if you have a significant underbite, overbite, open bite, or facial asymmetry, a consultation with our surgeons will clarify whether orthognathic surgery is indicated for your case.
The full treatment process — from starting pre-surgical orthodontics to completing post-surgical orthodontics — typically takes 2–3 years. Pre-surgical orthodontics usually takes 6–18 months, followed by surgery and recovery (most patients return to normal activity within 2–3 weeks), followed by post-surgical orthodontics of 6–12 months. While this is a significant commitment, the functional and aesthetic improvements are permanent and life-changing for most patients.
No. All incisions for orthognathic surgery are made entirely inside the mouth — there are no cuts on the face or external skin. The jawbones are accessed through the oral mucosa. This means there are no visible external scars whatsoever. Genioplasty (chin surgery), when included, is also performed through an intraoral incision.
Surgery is performed under general anesthesia, so there is no pain during the procedure. Post-operatively, significant swelling is expected and most patients experience moderate discomfort that is well managed with our opioid-free pain management protocol. Many patients describe the recovery as less painful than expected. The swelling — not pain — is often the most challenging aspect of recovery, particularly in the first week. Most patients are comfortable enough to return to school or desk work within 2–3 weeks.
In most modern orthognathic surgery, the jaw is not wired shut. Titanium plates and screws provide rigid internal fixation that holds the repositioned bones securely — allowing controlled jaw movement from early in recovery. Light elastics may be placed on the braces to guide the bite, but these allow some movement and are far less restrictive than traditional jaw wiring. A liquid and soft diet is maintained for several weeks while the bone heals.
Orthognathic surgery is frequently covered by medical insurance when it is performed to correct documented functional problems — such as difficulty chewing, significant bite misalignment, obstructive sleep apnea, or TMJ dysfunction. Coverage is determined by your insurance plan and the clinical documentation supporting medical necessity. We accept most major medical and dental insurance providers and Medicaid at all three DFW locations. Our team will work with you to navigate insurance authorization — contact us before your consultation.
A bite that works — a face that reflects you.
Our oral surgeons in Irving, Mesquite, and Ennis use cutting-edge 3D surgical planning and decades of surgical experience to deliver corrective jaw surgery results that are precise, predictable, and lasting. Schedule your consultation today.