Jaw Surgery for Recessed chin (Retrognathia, Skeletal Class II Malocclusion, or Mandibular Hypoplasia)

This orthognathic surgery (bone cutting and repositioning) is performed when a patient has a recessed lower jaw. The mandible (lower jaw) is too far back, which can lead to various issues:

Difficulty chewing (misalignment between upper and lower molars and canines)
Sleep apnea due to airway obstruction
Snoring
Jaw clicking or pain from temporomandibular joint (TMJ) dysfunction
Facial asymmetry: the lower face may tilt to one side when viewed from the front
Cosmetic concerns: receding or weak chin, double chin, aged appearance, short or long face, disharmony between the jaws

Orthodontic treatment is typically required both before and after surgery to ensure optimal aesthetic and functional results (chewing and breathing). The surgeon usually advances the lower jaw (mandibular advancement), and in some cases also works on the upper jaw (maxilla). This is referred to as a bimaxillary osteotomy. Skeletal Class II malocclusion may be combined with overall facial disproportions—either a “short face” (underdeveloped vertical height) or a “long face” (excess vertical height). The procedure leaves no visible facial scars. The surgeon accesses the jaw through the inside of the mouth, making incisions in the gums and using dissolvable stitches.

Surgery can be performed once bone growth is complete, typically at the end of adolescence. The earlier the procedure is done, the smoother the recovery tends to be. Titanium plates and screws used during surgery are not usually removed (except in rare cases). Titanium is biocompatible and won’t set off store or airport alarms.

Jaw Advancement Process (Orthodontics + Surgery)

Patients often consult an orthodontist for severe bite misalignment. The orthodontist begins treatment with braces and coordinates with an oral and maxillofacial surgeon to schedule surgery. Aesthetic outcome simulations can be performed with a profile photo on recessed-chin.com.

The patient then meets with the surgeon, who will explain the procedure and perform X-rays, CT scans, and 3D imaging.

Surgery details:

Performed under general anesthesia
Usually requires at least one night in the hospital
Post-surgery, the orthodontist continues treatment to perfect the alignment of the teeth.
One year after surgery, the patient typically has a well-aligned bite, a balanced profile, and a confident smile.

What to Expect During Surgery

Pre-surgery anesthesiologist consultation (at least 2 days prior)
Preoperative workup (blood tests, imaging, etc.)
Arrive at the hospital on an empty stomach
Surgery lasts 1–2 hours, followed by 2–3 hours in recovery
Most patients stay 1–2 nights in the hospital; some clinics offer outpatient surgery
At-home rest for at least 7 days, with cold compresses, a liquid diet, and rigorous oral hygiene to prevent infection

Recovery Timeline:

Day 15: jaw is “unlocked” by removing elastics; follow-up appointment; begin soft foods
3 months: most of the final results are visible; resume physical activity (except contact sports)
6 months: bones are fully healed

Cost of Lower Jaw Advancement Surgery

The total cost includes orthodontic treatment and the surgery itself. Prices range from $10,000 to $36,000 depending on complexity and the professionals involved. Bimaxillary surgery (upper and lower jaws) costs more than mandibular-only procedures.

3D Planning Technology for Jaw Advancement

In recent years, some maxillofacial surgeons have adopted 3D imaging tools to scan the facial skeleton and plan surgical movements virtually. This software helps visualize the procedure in three dimensions, ensuring that the bite will be properly aligned post-surgery.

A custom-made surgical splint is then 3D-printed and used during the procedure. After the bones are cut, the splint helps the surgeon precisely position the jaws before securing them with titanium plates and screws.