Orthognathic (Jaw) Surgery, Genioplasty & Distraction Osteogenesis

Dr. Stuart Super performs corrective jaw, or orthognathic, and genioplasty surgery to correct a wide variety of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth.

There are three main types of jaw surgery:

  1. Upper Jaw (Maxillary Osteotomy)
  2. Lower Jaw (Mandibular Osteotomy)
  3. Chin Surgery (Genioplasty)

In addition to Orthognathic Surgery, Dr. Super has perfected and pioneered techniques for Distraction Osteogenisis.  Although usually involved with the lower jaw or mandible, Dr. Super has also seen much success using the procedure with the upper jaw (maxilla).

Common Conditions Requiring Jaw Surgery

Lower Jaw & Chin Deficiencies

People often have underdeveloped lower jaws, or weak chins, This often has negative effects on the posture of the lower lip. There are several options available to correct this problem. The most effective aesthetic results are seen when we take the lower border of the lower jaw and slide it forward, After it heals in a few weeks the result is more natural looking and more stable than implants or other surgical techniques.

Large Protruding Lower Jaw & Lantern Jaw

People quite commonly have a severe under-bite which appears as a "lantern jaw effect or just a protruding lower jaw. The bite or occlusion usually requires orthodontics and surgery to adequately treat this problem. These patients suffer from some eating dysfunction as well as several aesthetic concerns. The cheeks are often flattened severely, the chin is often quite large both in a horizontal direction and a vertical dimension.

The surgical correction is often most successful aesthetically when both the upper jaw is moved slight forward and the lower jaw moved slightly back. Facial balance is more favorable in these cases because we can produce positive results around the nose, the cheeks the lips and the chin.

Gummy Smile & Long Face Syndrome

Some patients develop a long face problem which exhibits the following problems: a) gummy smile and difficulty in putting ones lips together; b) Severe flattening of the cheeks at the base of the nose, often making the nose appear larger than normal; c) Appearance of a short upper lip or a drooping of the lower lip.

Surgical correction of this problem usually require an operation of the upper jaw which repositions it into a superior position in relationship to the rest of the face. Results can be quite dramatic in that patients see a change in shape to the entire face, a relative shortening of the nose, a more relaxed poster to the upper and lower lip, and most important a more attractive smile. Also notice the changes around the cheeks and base of the nose.

Genioplasty and Cosmetic Chin Procedures

Many patients seek chin procedures, or genioplasty, to correct the position or size of their chins and restore facial harmony, balance and symmetry. Altering the appearance of the chin can have a great impact on a person's overall appearance.

Some patients seek chin augmentation for weak or small chins, whereas, others look for chin reduction or recontouring. We use an intraoral approach to recontour the patient's own chin bone and secure it in a more natural appearing position.

Chin procedures can often be performed as outpatient procedures in an ambulatory surgery setting. Patients often go home the same day. A chin dressing is placed around the chin and jaw to control postoperative swelling.

Most patients return to work within a few days after surgery.

On Genioplasty (Osteotomy of the Chin):
This procedure is performed through a small incision in the gingival below the lower front teeth and allows us to reposition the chin in almost any direction to correct any deficiency or excess in this area. Asymmetries can also be corrected with this procedure. The new chin position is fixed with titanium bone plates and screws and the healing time is a few weeks.

Distraction Osteogenesis

Today's healthcare system provides improved access to children and adolescents with mild to severe skeletal facial deformities.

This allows us to intervene and provide interceptive care at a younger age in an effort to help correct abnormal growth and prevent more complicated surgeries later in life.

Distraction Osteogenesis (DO) is a technique that allows for tissue expansion and bony movements at the same time. This advanced technology may be appropriate to minimize deformities in developing adolescents and safely expand tissues in patients such as:

  • Those with large defects of soft tissue and bone that may relapse with more conventional procedures.
  • Patients who have undergone many previous surgeries and have large amounts of scar tissue, that may cause relapse (such as cleft lip and palate patients or patients who have had accidents and trauma)
  • In patients who need dental implants or dental rehabilitation in the future.

Our approach is to custom-design DO appliances on a case by case basis to make them as patient friendly as possible. We take advantage of computer technology to integrate the use of CT scans to make actual replicas of the patient to customize the distractors. We prefer to use intraoral appliances, when possible.

This patient's left upper jaw failed to grow down normally.  She wore a small device inside of her mouth.  By turning the device everyday, the upper jaw grew down to a more normal position.

This is her bite at the end of treatment.  She went back to her orthodontist for continued work on her braces.


This patient's upper jaw did not grow enough.  He had a deep underbite.

The patient wore an intraoral (inside of the mouth only) upper jaw appliance.  By turning the appliance every day, his upper jaw grew forward.  This is how his bite looked at the end of treatment.