Surgical · skeletal
Orthognathic (jaw) surgery
Repositioning the jaws themselves. The largest change on this list, the longest commitment, and the only one that is usually a functional operation with an aesthetic consequence rather than the reverse.
Not medical advice. This page explains what a procedure is and what is known about it. It is not a recommendation, and it says nothing about whether you are a candidate for anything. Only a licensed provider who has examined you can tell you that.
What it maps to in LooksRatio
- Mandibular planehow steeply the jawline runs, which follows the position of the mandible itself
What it is
Surgery that cuts a jaw free and moves it to a new position, then fixes it there with plates and screws. The two workhorse operations are the Le Fort I osteotomy, which repositions the upper jaw, and the bilateral sagittal split osteotomy (BSSO), which repositions the lower jaw. They are often done together in a double jaw surgery.
This is normally done for a skeletal discrepancy: the jaws do not meet correctly and no amount of tooth movement will make them. The face changes because the bones the face is built on have moved.
How it works
Almost always in combination with orthodontics. Braces first, usually twelve to eighteen months, to line the teeth up within each jaw so the jaws can meet once they are in the right place. Then surgery. Then more orthodontics to finish.
The surgery is intraoral. The bone is cut in a planned pattern, the segment is moved to a position worked out beforehand from imaging and models, and titanium plates hold it while it heals.
Recovery
Two to six weeks before returning to work or school, with a liquid then soft diet for several weeks. Elastics guide the bite during healing. Swelling is dramatic in the first week, largely gone by six weeks, and fully resolved over several months.
The whole arc, braces to finish, is commonly two years or more. Nothing else on this list asks for that.
Risks and what actually goes wrong
The signature risk is neurosensory disturbance of the inferior alveolar nerve, which supplies sensation to the lower lip and chin. It is common early: in one 354-patient series, paresthesia was present in 31.6% to 39.3% of sides after sagittal split osteotomy.
Most of it resolves. A 579-case analysis found six-month recovery rates of 92.9% after sagittal split osteotomy and 94.4% after Le Fort I, with more than 85% of recovery happening in the first three months. Sensation that has not returned after a year is generally considered permanent. Mandibular advancement of 5mm or more was the strongest independent risk factor for bilateral involvement.
Also on the list: relapse of the new position, unfavourable splits during the osteotomy, infection, and hardware that occasionally has to be removed later.
Lower-commitment alternatives
Camouflage orthodontics can move teeth to compensate for a skeletal difference without moving the bone. It changes the bite, not the profile.
A chin or jaw angle implant changes the outline of the lower face without touching the position of the jaw or the bite. That is a different operation answering a different question, and it is a reasonable answer when the concern is purely how the jawline reads.
What LooksRatio assumes
The projection moves the mandibular plane 75% of the way to its ideal. It assumes a successful result and models none of the two-year timeline, the orthodontics, the bite, or the nerve. This measurement is also one where the photograph itself matters: a lifted or dropped chin changes the apparent angle, so check the reading against a level-headed photo before treating it as real.