Frequently Asked Questions

12 Aug 2015

FAQ regarding Orthognathic Surgery treatment plans and risks by Dr Alexander Antipov, D.D.S.

  1. Why do I need jaw surgery?

    • There are three reasons for orthognathic surgery (orthognathic means "straight jaw"):

    • to correct the bite

    • to address facial form and balance

    • to improve the airway (sleep apnea treatment)

  2. Why can't braces fix my problems?

    • your bite problem is extensive

    • your upper and lower jaws are not aligned properly

    • your bite is incorrect because of crooked teeth and misaligned jaws

    • braces can straighten crooked teeth but not misaligned jaws

    • attempting to straighten misaligned jaws with braces alone doesn't work

    • braces cannot correct sleep apnea nor other airway issues

  3. What are the options for correcting my particular problem?

    • braces only

    • braces and lower jaw surgery

    • braces and upper jaw surgery

    • braces and surgery to both jaws

  4. What determines which of the four options is used to treat my problem?

    • complete records are essential for arriving at the proper diagnosis

    • with the proper diagnosis, the correct treatment option is chosen

    • the correct treatment option will achieve:

      • facial balance

      • adequate airway

      • bite correction

      • bite correction stability

      • gingival health

      • TMJ health

  5. What if the wrong treatment option is chosen?

    • the bite is not corrected

    • bite changes relapse

    • facial decline occurs

    • the gums recede

    • the TMJ deteriorates causing the bite to change and increased pain

    • the airway is not improved

  6. Why would the wrong treatment be selected if it causes complications?

    • experience and training differences amongst clinicians

    • doctors focus solely on bite correction

  7. Can surgical treatment be accomplished without braces?

    • optimal results are obtained with braces

    • without braces surgical accuracy decreases and fine detailing of the bite is not possible

  8. How long will I have to wear braces before and after surgery?

    • BEFORE: generally between 9-12 months (but this is determined by your orthodontist)

    • AFTER: generally between 6 to 12 months

  9. Tell me about the practice

    • The practice consists of Drs. Jackson, Heise, and Alpha who practice a broad scope of oral maxillofacial surgery.

    • Dr. Jackson has a sub-specialty of corrective jaw surgery i.e. ~ orthognathic surgery which he has been performing for the past 30 years. Following his residency training, he spent a year in orthognathic surgery fellowship at St. Mary's Hospital and then did an additional 5 years in the practice doing orthognathic jaw surgery in St. Louis Missouri. He is a member and lectures at the prestigious Arnett Orthognathic Surgery Forum.

  10. Is this surgery considered cosmetic?

    • surgery which changes the bite and airway will produce facial balance

  11. Does insurance cover this type of surgery?

    • Many insurance companies do cover this kind of surgery, but each company is different

    • Margaret will work with you and your insurance company to maximize your benefit

  12. How often do I need to come to your office before surgery?

    • your orthodontist will communicate with Dr. Jackson every 3-4 months to review your progress

    • this will require impressions to be taken by your orthodontist

    • the models will then be sent to our office and reviewed by Dr. Jackson

  13. When may I schedule my surgery?

    • after Dr. Jackson and your orthodontist agree that your presurgical orthodontic preparation is complete

    • and after your insurance/finances are in order

  14. Where is the surgery performed and how long will I be in the hospital?

    • Mercy General Hospital or Sutter General Hospital depending on your insurance

    • you are admitted the morning of surgery and discharged 1-2 days later after you have met the discharge criteria

  15. How long is recovery?

    • You will need to be out of work for at least 10 days to two weeks and possibly longer if you have a job that relies heavily on speaking. It is possible that you will need to be out longer, depending on the extent of the surgery

  16. Is the surgery painful?

    • as a rule, patients do not complain of pain but rather discomfort related to swelling

    • pain medications address this discomfort adequately

    • pain medications are usually not needed after 5 to 7 days

  17. How much swelling occurs with the surgery?

    • swelling, extent, size and location is variable

    • 80% of the swelling is gone within 8-10 weeks

    • total resolution of unnoticeable residual swelling may take 12-18 months

  18. Will my jaws be wired shut?

    • no

    • light rubber bands between your upper and lower braces are used

    • orthodontic anchors will be utilized in addition to your orthodontic braces

  19. How and what can I eat?

    • There are four distinct dietary phases which begin with full liquid diet, non-chewing diet, soft foods, and then return to normal diet. You can expect to loose some weight (up to 10% of your body weight), mostly in the first two weeks of surgery. We will monitor your weight after surgery to make sure that you do not lose too much weight

    • Diet Timeline:

      • first 2 weeks is full time elastics. Removal of elastics permitted only in office. Diet is full liquid, particle free as in Ensure, Boost or particle free Jamba Juice.

      • next 6 weeks with full time elastics, you will be able to remove the elastics three times per day for diet, exercise, and hygiene. Diet is non-chewing which means any food that you can squash with your tongue and swallow without chewing.

      • at 3 months, you will have functional elastics which means you can speak and talk with the elastics on and your diet is soft

      • at 4 months, you may return to normal diet and exercise

  20. Will I be able to exercise after surgery?

    • low impact cardio exercise can start 4 weeks after surgery

    • high impact (running etc) and weight lifting can start at 8 weeks (no clenching)

    • contact sports or activities only after 6 months

    • be sure to obtain clearance from the doctor for any change in activity level

  21. When can I brush my teeth after surgery?

    • The goal is to keep you well-nourished and hydrated. In addition, maintaining adequate oral hygiene is equally as important. A Sonicare tooth brush and Water Pick is highly recommended for postoperative use after surgery.

  22. How soon after surgery can I become pregnant?

– female patients should wait 12 months after surgery to become pregnant

  1. Do I have to quite smoking before surgery?

    • YES!

    • you must quite smoking at least 2 months before surgery. If you do not quit with ample time, we will have to cancel your surgery date, as smoking prevents healing and encourages bone infection

  2. Are there any other restrictions after surgery?

    • you may not play a reed instrument until 12 months after surgery

    • scuba diving and snorkeling may start at 12 months

    • most sport mouth guards should not be worn until 1 year postoperatively, please check with your surgeon before doing so

    • check with Doctor before you wear any type of helmet. Chin pressure from the helmet straps can hurt your temporomandibular joint. In most instances, these types of helmets (that fit tightly over the chin) may not be worn for 12 months from surgery