Restoring Function, Balance and Facial Harmony
Orthognathic surgery, also known as corrective jaw surgery, is performed to improve the position of the upper jaw, lower jaw, or both jaws. The procedure can address problems with bite alignment, facial asymmetry, jaw function, and airway health while also improving overall facial balance.
Tom Pepper is a Consultant Oral and Maxillofacial Surgeon in London specialising in orthognathic surgery, facial skeletal surgery, and advanced facial aesthetics. Treatment is carefully planned to achieve both functional improvement and harmonious facial proportions.
What Is Orthognathic Surgery?
Orthognathic surgery involves repositioning the jaws to achieve a more balanced relationship between the teeth, jaws, and facial structures.
While orthodontic treatment can align the teeth, some problems are caused by the position of the jaw bones themselves. In these situations, jaw surgery may be required to achieve optimal function and long-term stability.
Orthognathic surgery may improve:
- Underbite
- Overbite
- Open bite
- Facial asymmetry
- Difficulty chewing
- Obstructive sleep apnoea in selected cases
The aim is not simply to move the jaws, but to create a balanced relationship between facial appearance, dental function, and breathing.
Conditions Orthognathic Surgery Can Treat
Underbite
An underbite occurs when the lower jaw sits further forward than the upper jaw.
This can affect:
- Facial balance
- Bite function
- Tooth wear
Corrective jaw surgery can reposition the jaws to improve both function and appearance.
Overbite
In some individuals, the upper jaw or teeth project significantly ahead of the lower jaw.
This may contribute to:
- Lip incompetence
- Difficulty biting
- Functional problems
- Facial disproportion
Orthognathic surgery can improve jaw alignment and facial harmony.
Facial Asymmetry
Facial asymmetry may result from developmental differences in jaw growth.
Treatment can improve:
- Jaw position
- Chin alignment
- Facial balance
Open Bite
An open bite occurs when the upper and lower teeth do not meet correctly.
This can cause:
- Difficulty chewing
- Altered smile aesthetics
- Long-term bite instability
Orthognathic surgery allows the jaws to be repositioned into a more functional relationship.
Orthognathic Surgery and Facial Appearance
Jaw surgery is often viewed as a functional procedure, but the effect on facial appearance can be significant.
Changes in jaw position influence:
- Chin projection
- Jawline definition
- Lip support
- Facial symmetry
- Neck and profile appearance
A detailed understanding of facial proportions is essential when planning treatment.
As a Consultant Oral and Maxillofacial Surgeon with expertise in facial aesthetics, Tom Pepper considers both the functional and facial consequences of every surgical movement. The objective is not simply to achieve a technically correct bite, but to create an aesthetic result that feels balanced, natural, and proportionate.
Orthognathic Surgery and Airway Health
The position of the jaws can influence airflow during sleep.
In selected patients, orthognathic surgery may form part of treatment for:
- Airway restriction
- Sleep-disordered breathing
- Obstructive sleep apnoea
Procedures such as maxillomandibular advancement (MMA) can significantly increase airway volume while also improving jaw position and facial balance.
Where airway concerns are present, these factors form an important part of the treatment-planning process.
Advanced Surgical Planning
Orthognathic surgery requires detailed planning.
Assessment typically includes:
- Clinical examination
- Photographic analysis
- Digital dental records
- CT imaging
- 3D virtual surgical planning
Digital planning allows the jaws to be evaluated in three dimensions and enables surgical movements to be simulated before the operation takes place.
This approach improves precision, predictability, and communication throughout the treatment process.
The Orthognathic Treatment Pathway
Treatment is usually carried out in collaboration with an orthodontist. Braces or aligners are often required before surgery to position the teeth appropriately.
Surgery
Procedures may include:
- Maxillary osteotomy (upper jaw surgery)
- Mandibular osteotomy (lower jaw surgery)
- Bimaxillary surgery (double jaw surery – upper and lower)
- Genioplasty (chin surgery)
- Surgically Assisted Rapid Palatal Expansion (SARPE)
Recovery
Healing occurs gradually over several weeks and months, with ongoing orthodontic refinement.
Recovery After Jaw Surgery
Recovery varies depending on the procedures performed.
Patients can typically expect:
- Swelling during the early healing period
- Temporary dietary restrictions
- Gradual improvement in comfort and function
- Progressive refinement of facial appearance
Most patients experience significant improvement within the first few weeks, although final results continue to develop over many months.
Comprehensive aftercare and guidance are provided throughout recovery.
Frequently Asked Questions
Will orthognathic surgery change my appearance?
Yes. Repositioning the jaws influences the relationship between the nose, lips, chin, and jawline. Changes are planned carefully to create natural facial balance while preserving individual identity.
Can jaw surgery improve facial asymmetry?
In many cases, yes. Orthognathic surgery can improve both functional asymmetry and visible facial imbalance.
Will I need braces?
Most patients require orthodontic treatment before and after surgery to achieve the best result.
Can jaw surgery help sleep apnoea?
In selected patients, corrective jaw surgery can improve airway dimensions and may play an important role in the management of obstructive sleep apnoea.
Am I too old for orthognathic surgery?
Provided overall health is appropriate, jaw surgery can be performed successfully in adults of many ages.
Why Choose Dr Tom Pepper?
Orthognathic surgery sits at the intersection of facial aesthetics, dental function, airway health, and facial skeletal surgery.
Dr Tom Pepper is a dual-qualified Consultant Oral and Maxillofacial Surgeon, trained in both medicine and dentistry, with extensive experience in facial reconstruction, orthognathic surgery, and advanced surgical planning.
Treatment is guided by:
- Detailed facial analysis
- 3D virtual planning
- Functional optimisation
- Long-term stability
- Natural facial balance
The result is a personalised treatment plan designed around the individual rather than a standardised surgical approach.
Consultation
Consultations for orthognathic surgery are available in London at Harley Street and Cromwell Hospital.
During your appointment, a detailed assessment will be performed to evaluate your bite, facial structure, and treatment goals, allowing a clear discussion of the most appropriate options for your individual circumstances.