How Jaw Surgery Works: The Procedure Step by Step
Medically reviewed by Dr. Sergio Calleja, DDS, MPH — Board-Certified Oral & Maxillofacial Surgeon · Last reviewed 2026-06-18
Orthognathic surgery is not a single event — it is a carefully staged process that typically spans two to three years from the first consultation to the final retainer. The operation itself usually takes one to four hours under general anesthesia, with most patients home the next day.
Here is the journey, step by step, as it happens at our practice.
- 1
Consultation and Records
Dr. Calleja and your orthodontist evaluate your bite, facial balance, airway, and jaw joints together. Records include photographs, X-rays, dental models, and a low-radiation 3D CBCT scan that maps your facial skeleton in detail. You will understand exactly what is out of position and why surgery — rather than braces alone — is the recommended fix.
- 2
Virtual Surgical Planning (VSP)
Your 3D scan becomes a digital surgical plan. The exact bone cuts and movements — down to the millimeter — are simulated on the computer, and custom surgical guides are fabricated for the operating room. VSP is how modern jaw surgery achieves precise, predictable results, and it lets you preview the planned change to your bite and profile.
- 3
Pre-Surgical Orthodontics (12–18 Months)
Braces move your teeth into the position they need to occupy once the bone is repositioned. A heads-up: your bite may temporarily look worse during this phase — the teeth are being aligned for your future jaw position, not your current one. This is normal and expected.
- 4
Surgery Day
The operation is performed in a hospital under general anesthesia — you are fully asleep. Incisions are made inside the mouth, so there are usually no visible facial scars. The planned cuts (osteotomies) are made, the bone segments are moved into their new position using the custom guides, and small titanium plates and screws lock everything in place. A single-jaw procedure typically takes about 1.5 to 2 hours; double jaw surgery about 3 to 4 hours.
- 5
Hospital Stay
Most patients stay one night for monitoring, fluids, and comfort. Some single-jaw cases go home the same day; complex cases occasionally stay longer. You will go home with detailed written instructions, prescriptions, and a direct line to reach us.
- 6
Splint, Elastics, and Early Follow-Up
Your jaw will not be wired shut in the vast majority of cases — the titanium fixation holds the bone. Instead, light orthodontic elastics (and sometimes a thin clear splint) gently guide your bite as it settles. Follow-up visits in the first weeks track healing, adjust elastics, and progress your diet.
- 7
Post-Surgical Orthodontics and Retention
Around six weeks after surgery, once initial bone healing allows, your orthodontist resumes fine-tuning the bite — typically for another 6 to 9 months. Braces then come off, and a retainer protects the result.
Why the Team Approach Matters
Successful jaw surgery is a partnership between your oral & maxillofacial surgeon and your orthodontist — the bone plan and the tooth plan must match perfectly. Dr. Calleja coordinates directly with referring orthodontists across Southern Maryland and the DMV throughout all phases, from initial records to retention.
Frequently Asked Questions
How long does the jaw surgery operation take?
Typically 1 to 4 hours under general anesthesia: about 1.5 to 2 hours for a single jaw, and 3 to 4 hours when both jaws are repositioned (double jaw surgery).
How long do I stay in the hospital after jaw surgery?
Most patients stay one night. Some single-jaw procedures allow same-day discharge, and complex cases occasionally stay two or three nights.
Are there visible scars after jaw surgery?
Almost never — the incisions are made inside the mouth. Occasionally one or two tiny external instrument marks are needed, which typically fade to near-invisibility.
What is virtual surgical planning?
A computer-guided process that converts your 3D CT scan into a precise digital surgical plan. The bone movements are simulated in advance and custom guides are printed for the operating room, making the surgery faster and more accurate than freehand techniques.
Can jaw surgery be done without braces?
"Surgery-first" protocols and clear-aligner approaches exist for selected cases, but most patients get the most stable, precise result with orthodontics before and after surgery. Dr. Calleja and your orthodontist will recommend the sequence that fits your anatomy.
Have Questions About Jaw Surgery?
Dr. Calleja evaluates every case personally at the Waldorf and California, MD offices — consultations in English or Spanish.
This page is general patient education, not personal medical advice. Every patient's anatomy and health history are different — treatment details, risks, and recovery vary case by case and are reviewed with you during your consultation. For emergencies, call 911.