Jaw Surgery Specialist

Up Pediatric Plastic Surgery

Pediatric Plastic Surgery located in Houston, TX & Webster, TX

If your child’s jaws aren’t aligned, it can not only affect their appearance, but their ability to speak, chew, and breathe. To correct misaligned jaws, Shitel Patel, MD, and Jacqueline Wegge, MD, offer jaw surgery at Up Pediatric Plastic Surgery that corrects most major problems, including moderate to severe overbite and underbite. If you’re in Houston or Webster, Texas, call one of the offices or schedule an appointment online to learn more.

Jaw Surgery (Orthognathic Surgery) Q & A

Why does my child need jaw surgery?

If your child’s jaws aren’t aligned, forming a moderate-to-severe underbite, overbite, or even a crossbite, it’s more than a simple matter of straightening their teeth. Children who had a cleft lip or cleft palate (or both) often suffer from a misalignment in their jaws that requires surgical intervention.

Other causes of a jaw misalignment include:

  • Hemifacial microsomia
  • Trauma
  • Isolated congenital anomaly

At Up Pediatric Plastic Surgery, the surgeons emphasize that a considerably misaligned jaw is more than an aesthetic problem. The problem can prevent your child from chewing, speaking, or breathing correctly.

In most cases, the doctors wait until your child is 16-18 years old to perform the surgery in order to obtain the best results.

What does the jaw surgery correct?

There are two general patterns of abnormal jaw relationships with multiple other variations in between.

  • Class III malocclusion or underbite: The surgeon moves your child’s upper jaw forward so that their upper teeth fit over their lower teeth. If the distance that the jaw needs to be moved is close to, or greater than, a centimeter, sometimes the surgeon moves your child’s lower jaw as well.
  • Class II malocclusion or overbite: The doctor moves your child’s lower jaw forward. If the lower jaw is small, it’s often beneficial to move the chin forward to balance out the profile and proportions of their face.

How is jaw surgery performed?

Before the day of surgery, the surgeons take special X-rays, as well as impressions of your child’s teeth, to create a surgical plan to meet your goals.

During surgery, the surgeon makes incisions on the inside of your child’s mouth and lifts the tissues off of the bone in those areas. In order to move the bones, the surgeon has to cut and release them from surrounding tissue. Once the bones are free, the surgeon moves them into their new position and fixes them there with metal plates and screws.

After checking the alignment of your child’s bite, the doctor closes the incisions with absorbable sutures.

What is recovery from jaw surgery like?

You should plan for a one- to three-day hospital stay. Your child can go home when they’re eating and drinking well and their pain is controlled.

You’re sent home with pain medication and antibiotics, and your child is able to shower. Your child has to stick to a soft diet for at least three weeks depending on how they’re healing, and they need to minimize exercise and activity for four to six weeks.

You should expect some bruising and swelling after surgery, and possibly some numbness of your child’s lower lip, chin, and cheeks due to nerve irritation. If there’s numbness, this may take months to resolve, but it’s rarely permanent. Swelling significantly improves after a week, but it may take several weeks to several months to completely resolve.

Because of the incisions in their mouth, your child has to be careful brushing their teeth, and they need to use a special mouthwash three times a day and after eating.

If your child is a candidate for jaw surgery, trust the surgeons at Up Pediatric Plastic Surgery. Call one of the offices or click to use the online booking tool to get started.

What is distraction?

Distraction osteogenesis is a surgical technique employed when bones need to move a far distance, usually greater than a centimeter.  At the time of surgery, cuts are made in the bone, and special hardware is applied that allows the bones to be slowly moved over time.  This allows the body to start forming bone in the gap created, and also helps to stretch the overlying soft tissues.  This results in better overall healing without the use of bone grafts, as well as a more durable result with less relapse.  The hardware has “arms” on the outside of the body which are turned with a screwdriver twice a day, or “distracted”. Distraction moves the bones 1-2 mm per day.  The process can last several days to weeks depending on the distance the bones need to travel.  Often you will be able to do the distraction yourself at home.  There are two different types of distraction hardware that are used.  “Internal” devices are attached to the bones inside of the mouth and have a small arm that extends to the outside for turning.  “External” devices, or the “HALO”, are like metal cages that attach to the skull from the outside and keep the bones stable while they are moving.  Once distraction is done, the hardware stays in place for approximately 6 weeks to allow the bone to heal and become solid.  We then bring your child back to the operating room to remove the hardware in a second procedure.  Typically, for distraction of the jaws we use internal devices, and for distraction of bigger parts of the face (such as the nose, cheek bones or eyes) we use the HALO device.