Orthognathic surgery is a surgical procedure that is intended to correct the size and/or position of the jaws, which is designed to improve the appearance and health of over all facial structures. Sometimes orthodontics alone can't achieve the level of the desired improvements in oral and facial structures due to extensive and severe problems that patients present with. Therefore, it is sometimes necessary to change the surrounding skeletal structures as well as teeth to elevate the patients' quality of life.
The surgical procedure is combined with orthodontic treatment because moving the jaws also moves the teeth. Usually the orthodontic treatment will begin first to set up the teeth for the surgery. This pre-surgical set up usually takes about 1 year. With braces on, patients then have the surgery to correct the skeletal problems. After the surgery, there is usually about 1 year of post-surgery orthodontics which tweaks and finishes the bite.

Most common facial imbalances that can be improved with Orthognathic Surgery are:

In some cases, only a specialist is able to recognize these problems. An evaluation should be carefully made by an orthodontist or an oral maxillofacial surgeon, in order to determine if a surgical repositioning is needed. Usually the treatment involves at least two professionals, such as an orthodontist and an oral and maxillofacial surgeon.

Orthognathic Surgery procedure usually takes from 3 to 4 hours, under general anesthesia.
Both jaws can be operated during the same surgery (Bi-maxillary osteotomy) or just one at a time (osteotomy).

Incisions will be made inside the mouth, in order to expose the bone of the mandible (lower jaw) and maxilla (upper jaw). The oral surgeon will then cut the bone of the jaw(s) and sometimes remove or even add part of the bone structure until he/she reaches the optimal position for the jaws. After the completion of the re-alignment of the jawbones, the oral surgeon will re-attach the jaws with the help of wires, titanium plates and screws.

Following the surgery, hospital stay may vary depending on procedures and operating room facility policies. At the first week following the Orthognathic procedure, special care should be taken. Patients should maintain an all-liquid diet at the first days following surgery and go slowly introducing soft food before hard food. Following the diet correctly helps the healing process.

Pain medication and prophylactic antibiotics will also be prescribed. Reactions such as facial discoloration and swelling are expected. Hard exercising should not be practiced before a month following surgery.

Depending on extent of the surgery; healing process might take from a few weeks to up to a year. Swelling usually disappears at the first weeks after surgery; however, some swelling might also remain a few months later. On average, Orthognathic Surgery recovery may be faster than recovery from an extraction of an impacted wisdom tooth.

The surgeon will accompany healing process, in order to make sure changes remain at the same place and also check if there is any infection.

Orthognathic surgery moves your teeth and jaws into a new position that is more balanced, functional and healthy.  Not only should you be able to bite and chew better than ever before, but your appearance and speech may be enhanced, as well.  The results of orthognathic surgery can have a dramatic and positive effect on many aspects of your life.

Not treating facial imbalances influences health and appearance. Problems such as difficulties to bite, chew, keep lips closed together and even speaking difficulties might appear when facial imbalances are not treated. Dental health, including gums and the jaw joint (TMJ) may also be in jeopardy. The reason for most people electing to correct facial imbalances through Orthognathic Surgery is the fact that it also improves appearance, making face look more balanced.