Jaw Surgery Risks and Safety: An Honest Look at the Evidence
Medically reviewed by Dr. Sergio Calleja, DDS, MPH — Board-Certified Oral & Maxillofacial Surgeon · Last reviewed 2026-06-18
Every surgery carries risk, and you deserve straight answers rather than reassurance. The good news: in the hands of a trained oral & maxillofacial surgeon, orthognathic surgery is a safe, well-studied procedure — large published series report overall complication rates in the single digits, and success rates around 94%.
Below are the risks that matter, what the published evidence says about how often they occur, and what we specifically do to reduce each one.
Numbness or Altered Sensation (the most common issue)
Nerves that supply feeling to the lips, chin, and cheeks run through the jaw bones. Nearly all lower-jaw (BSSO) patients notice temporary numbness of the lower lip and chin; upper-jaw surgery can cause temporary cheek and upper-lip numbness. Sensation recovers in the great majority of patients — studies report roughly 93–94% recovery by six months — but a small minority (around 3% at one year for lower-jaw surgery) keep some permanent altered sensation. Important: this affects feeling only, never facial movement.
How we reduce this riskDr. Calleja identifies and protects the nerve pathways on your 3D scan during virtual planning and uses careful surgical technique at the nerve-critical steps. You will know your personal risk profile — which depends on anatomy and how far the bone moves — before you decide on surgery.
Bleeding
Some bleeding during and after jaw surgery is normal. Serious hemorrhage is rare — published rates after Le Fort I surgery are below 1%.
How we reduce this riskSurgery is performed in a hospital with anesthesia techniques (controlled blood pressure) that limit blood loss, and your medical history is screened for bleeding risks in advance.
Infection
Surgical-site infections occur in roughly 1–5% of cases and are usually minor and treatable with antibiotics. Occasionally an infection develops around a fixation plate months later.
How we reduce this riskYou receive antibiotics at surgery, detailed oral-hygiene protocols for recovery, and structured follow-up visits that catch problems early.
Unfavorable Fracture ("Bad Split")
During the lower-jaw split, the bone can occasionally fracture along an unplanned line. Published rates vary widely (from under 1% to about 11%). When it happens, it is managed during the same operation with additional fixation and rarely changes the final outcome.
How we reduce this risk3D imaging reveals bone anatomy that predicts difficult splits — thin bone, impacted wisdom teeth in the path — so the technique is adapted in advance. This is one reason wisdom teeth are often removed months before jaw surgery.
Relapse (Bone Drifting Back)
The repositioned bone can partially drift back toward its old position, particularly after very large movements. Meaningful relapse is uncommon in modern series (reported in under 5% of studies).
How we reduce this riskRigid titanium fixation, realistic movement planning, and disciplined orthodontic retention after surgery are the proven defenses against relapse.
TMJ (Jaw Joint) Changes
Jaw joint symptoms can improve, stay the same, or occasionally appear after surgery — the joints adapt to a new bite position. Most changes are mild and settle during the first year.
How we reduce this riskPre-existing joint problems are evaluated before surgery and factored into the surgical plan, and joint position is respected during fixation.
Hardware Issues
The titanium plates and screws are biocompatible and designed to stay permanently. In roughly 6–7% of patients a plate later causes irritation or gets involved in an infection and is removed in a minor procedure.
How we reduce this riskLow-profile modern plates rarely cause problems; if one ever does, removal is a short outpatient procedure after the bone has healed.
Bite Imperfections and Revision
Rarely, the final bite needs more correction than planned — managed with orthodontics in most cases, and by revision surgery only in a small minority.
How we reduce this riskVirtual surgical planning with custom guides is the single biggest advance in making the planned bite and the actual bite match.
How to Think About These Numbers
National registry data puts the overall complication rate of orthognathic surgery around 4.5%, and most items on the list above are temporary or minor. The permanent risks — chiefly lasting sensory change — are real but affect a small minority, and you should weigh them against the daily, lifelong burden of the problem being corrected: a bite that does not function, progressive tooth wear, chronic strain, or untreated sleep apnea.
Surgeon training matters here. Oral & maxillofacial surgeons complete four to six years of hospital-based surgical residency focused on exactly these procedures. Dr. Calleja is board-certified by the American Board of Oral and Maxillofacial Surgery and fellowship-trained in cleft and craniomaxillofacial surgery — the most complex end of this field.
Call Us Right Away If You Notice
- Fever above 100.4°F (38°C)
- Bleeding that does not stop with gentle pressure
- Pain that worsens instead of improving after the first days
- Increasing swelling, redness, warmth, or discharge after the first week
- A change in your bite, or a plate/elastic that feels suddenly different
- Trouble breathing or persistent vomiting — for emergencies, call 911 first
Office: (301) 645-6911 (Waldorf) · (301) 863-8107 (California, MD). For emergencies, call 911.
Frequently Asked Questions
Is jaw surgery dangerous?
Orthognathic surgery is considered a safe, well-studied procedure when performed by a board-certified oral & maxillofacial surgeon in a hospital setting. Large published series report overall complication rates around 4.5–9%, most of them temporary, and success rates near 94%.
Is the numbness after jaw surgery permanent?
Usually not. Temporary numbness of the lip, chin, or cheek is expected — it is part of normal healing as the sensory nerves recover over 3 to 6 months. Published studies show roughly 93–94% of patients recover sensation by six months; a small minority (about 3% at one year after lower-jaw surgery) retain some permanent altered feeling.
Can jaw surgery paralyze your face?
No — the nerves at risk in orthognathic surgery carry sensation (feeling), not movement. The facial muscles are controlled by a different nerve that is not in the surgical field of standard jaw surgery.
Can jaw surgery fail or need to be redone?
True failure is uncommon. Minor bite discrepancies after surgery are usually corrected with orthodontics; revision surgery is needed only in a small minority of cases, most often after very large movements or unusual healing.
Do the titanium plates cause problems later?
Rarely. The plates are biocompatible, do not set off airport metal detectors in most cases, and are designed to stay for life. About 6–7% of patients eventually have a plate removed for irritation or localized infection — a minor outpatient procedure.
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.