What Is Double Jaw Surgery (Bimaxillary Osteotomy)?

What Is Double Jaw Surgery (Bimaxillary Osteotomy)?

If both your upper and lower jaws need repositioning, your surgeon may recommend double jaw surgery. Here is what it involves.

Double jaw surgery, also called bimaxillary osteotomy, is a procedure that repositions both the upper jaw (maxilla) and lower jaw (mandible) in the same operation. It is the most comprehensive type of orthognathic surgery.

• When is double jaw surgery needed?
• Both jaws are misaligned and need correction
• Severe overbite or underbite affecting both jaws
• Significant facial asymmetry
• Sleep apnea requiring both jaws to be moved
• Open bite that involves both jaws
• Long face syndrome or short face syndrome
• Previous facial trauma that healed incorrectly

• How it is done:
• Both upper and lower jaw procedures are performed in one surgery
• The upper jaw is repositioned first, then the lower jaw is set to work with the new upper position
• Incisions are made inside the mouth — no external cuts
• Titanium plates and screws hold both jaws in place
• A surgical splint is often used to align the bite during surgery

What to Expect

• Surgery takes 3–6 hours (longer than single-jaw surgery)
• Hospital stay of 1–3 nights
• More swelling than single-jaw surgery (both levels of the face)
• More post-operative numbness (both upper lip and lower lip areas)
• Liquid diet for 2–4 weeks, then soft foods for 4–6 weeks
• Elastic bands to guide the bite during healing

Recovery Considerations

• Because both jaws are involved, recovery may be more extensive:
• More overall fatigue in the first 2 weeks
• Swelling affects the entire face, not just one area
• Eating and speaking may be more challenging initially
• The result is typically the most balanced and functional outcome

Clinical Guidance

Double jaw surgery (bimaxillary osteotomy) repositions both upper and lower jaws in one procedure for complex bite problems, facial asymmetry, and sleep apnea. It involves a longer surgery and recovery than single-jaw procedures but provides the most comprehensive correction.