Orthognathic surgery

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Orthognathic surgery


Orthognathic surgery is one of the most powerful, life-changing facial interventions.

It consists of the repositioning of the maxilla, mandible and chin. ORHTO means alingment and GNATHIC comes from the Greek word for the jaw.

Beyond facial aesthetics, the primary goal is to improve: breathing; dental occlusion; and correct mastication. So, do not take orthognathic surgery as only a vain procedure to serve aesthetic trends. It is definitely a functional surgery, rather than just a mere cosmetic intervention.

Face: an unique feature

The face is our most unique and distinguishable feature.

Several genetic and environmental factors play together for the final adult facial morphology.

For example, air passage through the nose is a very important stimulus for mid-face development. Children without correct nasal breathing may not develop correct maxillary and mid-third facial size. Also, the mandible may tend to grow downward.

The spectrum of facial  imbalances range from a mismatch of proportions of rather normal facial structures (which account for the majority of the cases) up to some pathologies, such as: cleft palate, craniosynostosis or hemifacial microsomia, moving into a broader field called: craniofacial surgery.

Facial proportions vs Facial beauty

To achieve a well-balanced face, there are proportions of facial soft tissues and skeleton landmarks that must be taken into consideration.

These proportions are the result of big anthropometric data, collected during the second half of the last century that have been getting more matured including: x-rays, photographic and computerized analysis.

The first big data assessed the caucasian population, but there are several recent publications studying its applicability in other populations. These guidelines help to achieve what is believed to be a harmonious face for each individual, when considering an orthognathic surgery.

It is also  believed that a well-balanced face skeleton can preserve a younger profile, compared to those with insufficient or poorly defined features. Whether those anthropometric guidelines  translate directly into good facial aesthetics and attractiveness, will remain an open answer.

The canons of beauty have evolved and have been reinvented several times, from the Greek Hellenic scholars, up to the modern media pop culture. Comparing the current anthropometric guidelines and the results from beauty contests, showed that the definition of a good looking face does not exactly match mathematical models. Actually attractiveness includes other components such as expressiveness, beyond the mere static facial framework.

In sum, to quote the famous Irish novelist Margaret Hungerfort: beauty is in the eye of the beholder. This means that expectations of subjective definitions of beauty results must be addressed cautiously, before a jaw surgery.

Facial functionality

Orthognathic surgery is one of the facial intervention with more impact, not only in the facial morphology, but also in head and neck functions, in particular: breathing.

A bimaxillary  surgery is a total upper airway surgery, with clear advantages. A maxillomandibular advancement compared to other interventional techniques, procudes higher rates of cure and success in obstructive sleep apnea patients, carefully selected after sleep studies and airway imaging.

orthognathic jaw surgery sleep apnea

To provide the full functional and morphological balance, the surgical plan might include, not only orthognatic surgery, but other interventions, either at the same surgical time or at a delayed time, such as: septoplasty, rhinoplasty or cheek surgical modulation.


There are dozens of different treatment protocols, but the most common one is as follows:

  • Orthodontic preparation phase, where teeth will be aligned for the final position. During this phase the disparities tend to be exacerbated.
  • Then, surgery is performed: bone cuts and movements are designed accordingly to each case. The big majority of the cases leave no skin scar, as cuts are done inside the mouth.
  • After surgery, there will be an  orthodontic finalization and stabilization period.

Recover from surgery

Postoperative reactions tend to vary but the general timeline goes as follows:

  • You usually stay in hospital one or two nights.
  • Back home, you will be able to walk and do most non-strenuous daily activities; with a soft diet
  • Swelling tends  to go down within 2 weeks and by this time a semi-solid diet can also be introduced;
  • You can restart sporting activities after 2 months;
  • Soft tissues will re-adapt the new skeleton frame and the final expected results will be stable from the 6th month after the end of the treatment.

Remember this is just a general timeline and do not take it for granted that this will be just like that for you.

For example, smokers and patients with chronic illnesses tend to have longer recovery time.


The main and most concerning side effect of jaw surgery is the chin numbness. Not all patients are affected. Complete damage of the nerve is a non-negligible risk,  but recent imaging technology and piezo instruments, that use ultrasound cutting technology, tend to reduce this risk.

Orthognathic surgery produces highly stable results. However, there can be a regression, usually of some millimeters, rarely to the same preoperative position.

Why this? Because the muscle system will try to pull the skeleton back to its previous position. This risk will be reduced when using high quality fixing material, correct planning and surgical technique and if the patient complies correctly with the treatment plan.

MD, DSS, Miguel Lopes Oliveira

Maxillofacial Surgeon

At Faces, we offer a wide range of specialized services in facial health. Our highly qualified team is ready to meet your individual needs. In our clinic, you will find a global and comprehensive approach to facial and neck surgery, achieving results beyond restoration.

We provide treatments for conditions such as temporomandibular joint dysfunction, orthognathic surgery, salivary gland problems, neck conditions, snoring and sleep apnea, tear duct and eyelid issues, facial fat grafting, and trauma-related injuries.

Our dedicated team is here to answer all your questions and provide the most suitable treatment for you. Schedule a consultation with us today and discover how we can help you.

Pedro Costelas
Pedro Costelas
Recentemente fui submetido a uma cirurgia Maxilofacial para retirar um tumor benigno, tendo a mesma sido efetuada pelo Dr. Miguel Oliveira. A cirurgia não podia ter corrido melhor só tendo a agradecer ao Dr Miguel o seu grande profissionalismo e o interesse que demonstrou em resolver o meu problema, que tanto me preocupava. A intervenção correu muito bem, assim como a posterior recuperação. A cicatriz mal se nota pelo excelente trabalho efetuado pelo Dr. Miguel. Mais uma vez o meu Muito Obrigado por tudo!!!
Teresa Canário
Teresa Canário
Fui intervencionada recentemente a um enorme lipoma pelo Dr. Miguel Oliveira e não quero deixar de destacar o extremo profissionalismo, simpatia, empatia com que conduziu todo o meu processo. De destacar ainda a forma descontraída com que sempre me tratou, o que ajudou em muito a que eu acreditasse que estava realmente nas mãos certas. O resultado foi perfeito, a cicatriz é quase invisível e ninguém acredita que daquele tão pequeno espaço saiu um lipoma tão grande. Quero agradecer profundamente ao Dr. Miguel por todo o seu excelente trabalho!
Tânia Calisto
Tânia Calisto
O Dr. MIGUEL foi impecável. Super atencioso, simpático e prestável. Foi muito esclarecedor.
Anabela Correia
Anabela Correia
O Dr. Miguel Oliveira é um profissional de excelência. A cirurgia reconstrutiva q fez ao olho esquerdo do meu pai fIcou PERFEITA. O meu pai tem 82 anos e foi alvo de violência q o deixou com várias lesões no rosto em especial na zona ocular e o Dr. Miguel foi de uma atenção, empatia e perfeccionismo inexcedível. Obgada.
Mariana Rosa
Mariana Rosa
Excelente médico, sempre disponível fossem que horas fossem. Durante a recuperação ligou várias vezes para acompanhar ao máximo a recuperação apesar de não estar perto. Aconselho!
Mario Reis
Mario Reis
As consultas e a cirurgia com o Dr. Miguel Oliveira decorreram de forma tranquila, serena, com toda a informação. A intervenção evidenciou elevado nível de competência profissional. Grato pelos serviços profissionais prestados.
maria anjos
maria anjos
Sempre considerei que profissionalismo e competência é o que devemos valorizar em qualquer área mas sobretudo na saúde. Quando nada o fazia prever foi-me diagnosticado um carcinoma mucoepidermoide. Em boa hora conheci o Dr. Miguel Oliveira e desde o primeiro momento senti uma enorme confiança. Fui operada e até hoje continuo a ser acompanhada por ele. Embora ainda não se possa cantar vitória, o certo é que até agora tem tudo corrido bem. Bem haja Sr. Dr. Miguel Oliveira.
pedro brandao
pedro brandao
Consulta que demonstrou confiança serenidade e competência no diagnóstico clínico .Fui recebido a horas e decorreu com a urbanidade que esperava.

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Beyond Restored

A global and comprehensive approach to facial and neck surgery.

Use the contact details below to contact us about "Orthognathic surgery" in Lisboa or Évora
FACES, Facial Surgery ® - registered trademark
www.faces.pt - MD, DSS, Miguel Lopes Oliveira
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