Orthodontic Surgery

Orthodontics means straightening of your teeth by using braces. However, ‘orthognathic surgery” is needed if your jaw bone (s) as well as teeth need to be repositioned. For example, your teeth and jaws are not  positioned well, resulting in what is colloquially called a ‘bad bite’ which may have a greater effect on your facial aesthetics and function. For example, cases of people with severely protruded maxilla (upper jaw) such that your lips cannot close without effort, and there is a lot of vertical gum display when smiling (gummy smile); or cases of protruded, jutting mandible (lower jaw), accompanied by a rather long face with lower teeth biting outside the upper arch and a thickish lower lip. This large lower jaw has an interesting historical reference – it is called the Hapsburg Jaw or Hapsburg Lip after European royalty, the Hapsburg House, many centuries ago. Other cases which may call for orthognatic surgery would be patients with severe facial asymmetry (one side of your face is not symmetrical with the other side, and thus, not pleasing to the eye); or  cases of a markedly small lower jaw (‘bird face”).

Sometimes, such patients will face functional issues (such as not being able to bite noodles properly with their front teeth if they have protrusive lower jaws). Others seek treatment for aesthetic reasons. In such cases,   Dr Kenneth Lew, a specialist orthodontist, will work with our oral-maxillofacial surgeon, to place braces on your teeth to put them in a proper alignment before surgery which is under general anaesthesia (in a hospital of your choice). After you recover and the post-surgical swelling subsides, the results of your orthognathic surgery can be rather dramatic. It is important for the patient and loved ones to be psychologically prepared for a  this sudden, visible improvement. Please do consult with us to understand better your expectations, the functional and aesthetic possibilities and limitations pertaining to orthognathic surgery.


Knowledge about orthognathic, plastic and reconstructive surgery to the jaws grew by leaps and bounds during the first and second World Wars? Surgeons operated on soldiers with severe wounds to the face and jaws caused by firearms and explosive gunpowder, compelled by compassion to “reconstruct” these soldiers’ faces for  a meaningful civilian life after the war. Do visit the Hunterian Medical Museum, Royal College of Surgeons, Lincoln Inns’ Field  which has intriguing exhibits.

WHAT IF… orthognathic surgery were sophisticated centuries ago?

Perhaps the course of history would be different. Generations of  European royalty then VISUALLY recognized by their characteristic  HABSBURG JAW AND HABSBURG LIP , would have been able to alter their lower jaws. Even then, the long lower jaw was regarded as visually challenging. Remember too, that blood tests for legitimacy of heirs was not available then. Legitimacy of birth had  to be evidenced  by witnesses in the royal childbearing chamber.  Perhaps certain historical outcomes would have been different.


When you next visit a museum or look at the oil paintings of the Old Masters, notice that Mona Lisa painted with reverence as the Ideal Beauty, had a smallish chin. Historically, a pert chin, small neat nose, large limpid eyes was regarded as feminine.  A long jaw was even then, was not  consonant with feminine charms.