Your facial shape and your jaw’s position play vital roles in many functions of daily life, including breathing, eating, swallowing and speaking. Facial harmony aligns your teeth and chin properly and allows them to work seamlessly with your facial muscles and jaw joints. Jaw surgery, or orthognathic surgery, can help correct various facial and dental deformities and functional dental issues, as well as cosmetically change the shape and proportions of your face.
Facial bone contouring surgeries are frequently performed in Asia, where beauty standards tend to favour a soft, delicate facial shape rather than an angular and defined jawline. Double jaw surgery, also called two-jaw surgery or bimaxillary osteotomy, is an effective procedure for patients seeking functional and/or cosmetic improvement involving both the upper and lower jaw.
If you would like to know more about this procedure, you may find answers to your questions below. Please contact the specialist plastic surgeons at Asian Plastic Surgery to book a consultation and get answers to any additional questions.
Why Is It Called Double Jaw Surgery?
Orthognathic surgery often addresses one jaw at a time. As independent procedures, maxillary osteotomy focuses on the upper jaw, or maxilla. Mandibular osteotomy focuses on the lower jaw, or mandible. Bimaxillary osteotomy corrects both jaws simultaneously, earning it the nickname double jaw surgery.
Operating on both jaws at once gives the surgeon the most flexibility to adjust the jaw bones and shape the face, giving the patient the best chance for a natural, aesthetically pleasing outcome. With this holistic approach, the surgeon attempts to improve all functional and cosmetic issues by reshaping, resizing or repositioning the upper and lower jaws to bring them into more optimal positions.
Why Is Double Jaw Surgery Popular With Asians?
Double jaw surgery enhances the relationship between the mid-face and lower face. In some Asian populations, it is common to see a retruded mid-face, a chin that is considered ‘too strong’ or ‘too weak’, and flaring of the front teeth. Combined, these attributes create a convex facial profile that some seek to change with surgery.
Due to common traits of Asian anatomy and aesthetic preferences in many Asian countries, double jaw surgery is popular with Asian patients worldwide. However, it is important to note that it is not restricted to any particular ethnic group.
Why Would Someone Need Double Jaw Surgery?
Double jaw surgery can improve a variety of functional issues related to abnormal formation of the jaw, including:
- Malocclusion (misalignment of the upper and lower teeth)
- Underbite
- Overbite
- Open bite
- Headache due to chronic malocclusion
- Difficulty swallowing, biting or chewing food
- Speech problems
- Uneven wear of the teeth
- Pain in the jaw joints (TMJ)
- Chronic mouth breathing
- Inability to seal the lips over the teeth and resulting facial muscle tension
- Obstructive sleep apnea
For patients with functional concerns, a multidisciplinary collaboration between a plastic surgeon and other specialists (e.g. an orthodontist) often yields the best results.
Is Double Jaw Surgery Cosmetic?
Double jaw surgery can have both functional and cosmetic benefits, or it can be purely cosmetic. Patients may seek out this procedure for aesthetic concerns such as:
- Facial asymmetry
- Gummy smile
- Recessive jaw
- Protruding jaw
- Jutting chin
- Protruding mouth
- Long face
Orthognathic surgery is one of the most powerful facial cosmetic procedures. Changing the size, shape, angle and/or alignment of the jaws can dramatically change facial balance and aesthetics.
How Is Double Jaw Surgery Different From V-Line Surgery?
Double jaw surgery concentrates on issues pertaining to the two jaws and how they interact with one another. It can be applied to a wide variety of functional and cosmetic issues.
V-line surgery affects the lower jaw only. The bone is filed down and a portion of bone is removed to achieve a more slender and feminine lower face shape. V-line surgery can change a patient’s face shape from square to oval and create a sharper chin profile. It is cosmetic only; V-line surgery does not affect the ability to speak, chew, swallow or breathe.
What Is Aesthetic Facial Bone Contouring?
V-line surgery is a type of aesthetic facial bone contouring. Procedures that fall into this category focus on reshaping and resizing facial bones purely for aesthetic enhancement, rather than for functional benefits. Techniques may include shaving, burring or reducing bone (e.g., prominent jaw angles, overly wide cheekbones) or augmenting bone (e.g., chin implants or sliding genioplasty for a weak chin).
Aesthetic bone contouring does not change your bite (occlusion). Because the bite isn't altered, orthodontic preparation is not required for these procedures.
Other key differences between functional orthognathic surgery and aesthetic bone contouring are found in the risks and recovery experiences. Purely cosmetic procedures may involve less overall swelling and lower risks, as the manipulation is often more localised to the bone surface. However, any surgery carries risks that must be discussed with your surgeon.
What Other Forms of Facial Contouring Surgery Can Benefit Asian Patients?
Bone contouring surgeries have a profound aesthetic impact because they alter the foundational structure of the face. The impact often exceeds what can be achieved with soft tissue manipulation alone, yet looks flattering and natural. Plastic surgeons often combine facial contouring surgeries for comprehensive and harmonious results.
Many patients see a plastic surgeon with rhinoplasty in mind, only to find out that their concerns would be better addressed with jaw surgery. For some individuals, a combination of jaw surgery and rhinoplasty produces the most balanced result. Genioplasty is an option for patients with concerns relating to the chin, such as a receding chin or protruding chin.
When multiple surgeries are planned, we may recommend a staged procedure (an operation undertaken in two or more separate parts) to facilitate healing and assess the patient’s evolving facial aesthetics on an ongoing basis.
Who Performs Double Jaw Surgery?
Bone contouring is a highly specialised area of plastic surgery. Designing the ideal facial aesthetic for a patient requires an advanced skill set, meticulous attention to detail and the highest understanding of facial anatomy. The process involves a combination of 3D imaging, surgical planning software, analysis of a patient’s bite and airway, and more, to create a treatment plan that optimises both cosmetic and functional long-term outcomes.
Our Specialist Plastic Surgeon, Dr Quan Ngo, has a particular interest in bone contouring and reshaping work focusing on the head and neck region. Following the completion of his Plastic & Reconstructive Surgery training in Sydney, Dr Ngo acquired further specialist fellowship training in the UK, France and Taiwan. He is pioneering in his use of 3D imaging and 3D printing in Australia, and incorporates both of these technologies into planning jaw surgeries.
Am I a Candidate for Double Jaw Surgery?
Making the decision to undergo surgery is never taken lightly, especially when it involves something as central to your daily function as your jaws.
Consultation
A consultation is the first step. You will meet with Dr Ngo to discuss your concerns, goals, medical history and procedure options. Expect a thorough examination of your face, jaws, teeth and bite. Photos and preliminary X-rays may be taken. Use this initial meeting to raise any questions or concerns you have about the procedure.
Testing
Comprehensive assessment before surgery includes:
- Complete medical history review
- Physical examination
- Blood tests
- Imaging studies (CT scans, X-rays)
- Airway evaluation if breathing issues are present
- Dental models and bite analysis
Treatment Planning
The planning process for orthognathic surgery is detailed. In addition to X-rays, the preoperative process may involve dental impressions to create models of your teeth and 3D digital visualisation to simulate the surgery on a computer. Today’s advanced virtual planning tools help surgeons plan the precise cuts (osteotomies) and movements needed (advancement, setback, impaction, rotation) for a specific procedure.
What Happens During Double Jaw Surgery?
Double jaw surgery is performed in a hospital setting under general anaesthesia, meaning you will be asleep throughout the procedure. An experienced anaesthetist will monitor you closely.
Almost all incisions are made inside the mouth, within the gums of the upper and lower jaws. This means there are typically no visible external facial scars.
While each procedure is customised, the most commonly used techniques are:
- LeFort I Osteotomy to address the upper jaw
- Bilateral Sagittal Split Osteotomy (BSSO) to address the lower jaw
Once the jaws are repositioned, they are secured in place using plates and screws. These typically remain in place permanently and integrate with the bone.
The duration of the operation varies depending on the complexity of the case. Double jaw surgery typically takes 3 to 6 hours.
How Long Is the Recovery After Double Jaw Surgery?
Recovery from double jaw surgery involves an initial six to eight week healing phase, with full bony healing taking eight to 12 weeks. Complete recovery and settling of the final results can take up to one year.
While everyone heals differently, here is a general timeline of what to expect after double jaw surgery:
Immediately After Surgery
- Expect swelling and facial bruising. Swelling typically peaks around day three to five post-op.
- Numbness in the lower lip, chin and sometimes upper lip/cheeks is common due to nerve manipulation.
- Pain will be managed with prescribed medications.
- Your diet will be strictly liquid.
- You may have small drainage tubes and elastic bands guiding your bite.
The First Two Weeks
- This is often the most challenging phase. Swelling and bruising remain significant but will gradually start to decrease after the first week.
- Diet remains liquid/pureed (think smoothies, soups, yogurt, protein shakes).
- Oral hygiene is critical but modified — gentle rinsing with prescribed mouthwash, possibly using a soft-bristled toothbrush.
- Your activity level should be very light. Avoid bending, lifting or strenuous activity. Short, gentle walks are usually encouraged after a few days.
Weeks Two to Six
- Swelling continues to decrease, revealing more of the surgical changes.
- You'll likely transition to a soft, non-chew diet (e.g., scrambled eggs, mashed potatoes, soft pasta, well-cooked fish, oatmeal). Absolutely no hard or chewy foods.
- Your surgeon may recommend starting gentle jaw opening exercises.
- You might be able to return to work or school after two to four weeks, depending on your comfort level and job demands. Avoid strenuous activities for at least six to eight weeks.
Months Two to Three
- Most of the significant swelling should be gone, though subtle swelling can persist for months.
- You can gradually introduce foods that require minimal chewing, as advised by your surgeon.
- Post-surgical orthodontics may begin or continue during this phase to fine-tune your bite.
- Numbness continues to improve, though complete resolution can take longer.
- You can resume most normal activities, including light exercise, as cleared by your surgeon.
Six Months to One Year
- Bone healing is generally complete and stable by six to 12 months.
- Your final aesthetic results become fully apparent as residual swelling resolves.
- Orthodontic treatment is usually completed, and retainers are provided.
- Nerve sensation typically continues to recover. It can sometimes take 18 months or longer for maximum improvement. In some cases, small areas of altered sensation may persist long-term.
- Enjoy the results of your new jaw alignment!
What Is the Cost of Double Jaw Surgery?
The total cost includes a variety of fees, including surgeon's fees, hospital/facility fees, anaesthesia fees and preoperative diagnostics. Costs vary based on surgical complexity, geographic location and provider experience. In general, patients seeking double jaw surgery in Sydney should expect the procedure to cost $20,000-$50,000.
Our expertise and focus at Asian Plastic Surgery centre on cosmetic facial bone contouring. The principal goal of our surgeries is aesthetic enhancement. Consequently, the procedures do not qualify for coverage through Medicare and private health insurance. The costs are typically self-funded by the patient.
During your consultation, you will receive a detailed, itemised quote covering all anticipated fees associated with your procedure. This ensures you have a clear understanding of the investment involved before moving forward.
Contact Asian Plastic Surgery to Learn More About Double Jaw Surgery in Sydney
If you are looking for a way to make a dramatic change in the structure of your face, double jaw surgery could be the solution. We invite you to request more information about this procedure by filling out our enquiry form or calling 02 8962 9388 to schedule a consultation.
