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Condylar Hyperplasia

Excess condylar growth affecting facial balance, with effective treatment and lasting results

What Is Condylar Hyperplasia

Understanding Condylar Hyperplasia

Condylar hyperplasia is a condition involving excessive growth of the mandibular condyle, the portion of the lower jaw that forms the jaw joint (TMJ). It most commonly affects one condyle and can cause the lower jaw to gradually lengthen or shift as growth continues, leading to facial asymmetry, chin deviation, bite changes, and progressive imbalance of the lower face.

Close-up of woman's face showing mandibular asymmetry.

Clinical Presentation

Clinical presentation of mandibular asymmetry, profile view.
Side View

Profile Analysis

Profile evaluation focuses on progressive changes in jaw position and facial balance over time. In condylar hyperplasia, continued condylar overgrowth may gradually shift, lengthen, or rotate the lower jaw as asymmetry develops.

Key Assessments:

Mandibular elongation
Abnormal jaw rotation
Altered facial contours
Asymmetric growth trajectory
Clinical presentation of mandibular asymmetry, frontal view.
Frontal View

Frontal Analysis

Frontal examination evaluates changes in symmetry over time. Condylar hyperplasia often presents with increasing chin deviation toward the unaffected side as growth progresses.

Key Assessments:

Progressive chin deviation
Lower facial asymmetry
Jaw width imbalance
Soft tissue distortion
Clinical presentation of mandibular asymmetry, occlusal view.
Bite View

Occlusal Relationship

Occlusal analysis examines how abnormal joint growth alters bite contact. Progressive malocclusion may develop as one side of the jaw lengthens unevenly.

Key Assessments:

Progressive malocclusion
Midline shift progression
Unilateral open bite or crossbite
Occlusal plane canting

Condylar Hyperplasia

Common Functional Issues

Icon representing eating and chewing.

Eating

Uneven jaw growth can disrupt chewing mechanics, leading to imbalance and fatigue during mastication.

Icon representing speech.

Speech

Progressive asymmetry may interfere with coordinated jaw movement, subtly affecting speech clarity.

Icon representing TMJ symptoms.

TMJ Function

Active condylar overgrowth can cause joint discomfort, clicking, or altered movement patterns.

Icon representing jaw fatigue.

Jaw Movement

Asymmetric growth may lead to deviation during opening or closing of the mouth.

Icon representing bite stability.

Bite Stability

Ongoing growth can destabilize previously corrected bite relationships.

Icon representing physiological factors.

Psychosocial Effects

Gradually worsening facial asymmetry may impact self-esteem and emotional wellbeing.

Before & After Gallery

Surgical Management of Condylar Hyperplasia

Mandibular Surgery (BSSO)

Once condylar growth has ceased, bilateral sagittal split osteotomy corrects the skeletal asymmetry caused by condylar hyperplasia by repositioning the mandible to level the chin, correct the lateral deviation, and reestablish a balanced bite. Differential positioning of each side allows precise asymmetric correction tailored to the degree of overgrowth. The repositioned jaw is secured with titanium plates and screws, improving chewing, speech, and facial symmetry. Each case is planned with advanced imaging and surgical simulation.

Double Jaw Surgery

When condylar hyperplasia has produced a maxillary cant or additional skeletal discrepancies, double jaw surgery is performed once condylar growth has ceased. A Le Fort I osteotomy corrects the upper jaw cant through differential impaction while a bilateral sagittal split osteotomy simultaneously repositions the lower jaw to correct the chin deviation and reestablish facial symmetry and balance. Both jaws are secured with titanium plates and screws, improving chewing, speech, breathing, and facial harmony. Each case is planned with advanced imaging and surgical simulation.

Presurgical Considerations

Cleft lefort recovery.

Growth Assessment

Key Assessment Points:

Bone scan evaluation of activity
Serial imaging comparison
Clinical progression monitoring
Timing of intervention determination
Female wearing braces.

Orthodontic Coordination

Key Assessment Points:

Management of evolving bite changes
Avoidance of premature correction
Preparation for post-growth alignment
Midline compensation control
Clinical jaw evaluation with a patient.

TMJ Evaluation

Key Assessment Points:

Joint imaging and analysis
Assessment of pain or dysfunction
Range of motion documentation
Baseline functional records

Treatment Timeline

Month 0

Initial Consultation

History, clinical evaluation, 3D scans, X-rays, photographs, and impressions.

1–2 weeks

SPECT / Bone Scan

Nuclear medicine imaging to confirm active vs. inactive condylar growth.

2–4 weeks

Treatment Planning Visit

Records reviewed, orthodontist coordinated, prediction images and plan presented.

6–12 months

Orthodontic Preparation

Braces or aligners align teeth in preparation for surgical correction.

3–6 weeks prior to surgery

Final Surgical Planning

Virtual surgical planning determines precise movements for optimal outcome.

2–4 weeks prior to surgery

Pre-Op Medical Clearance

Medical exams, lab testing, and final instructions before surgery.

Surgery day

Surgery

Single or double jaw surgery with or without condylectomy, based on whether active condylar growth is present.

3–9 months after

Post-Surgical Orthodontics & Long-Term Follow-Up

Experience Matters

“We personally plan your care, perform your surgery, and guide your recovery. No residents, no fellows, no handoffs.

Choosing the right surgical team matters. You should feel informed, comfortable, and confident in every step of the process. At our practice, your care is provided by one of the most highly trained and experienced jaw surgery teams in the country.

When you come to our office, you meet directly with your surgeons. We are the ones who plan your treatment, perform your surgery, see you after surgery, and remain personally available to you throughout your recovery. Unlike larger institutions, your care is not delegated to residents, fellows, or doctors in training. Every critical aspect of your treatment is handled by your surgeons.

Founding Members of the American Society of Orthognathic Surgery

What Our Patients Are Saying

Handsome young man, blue shirt, short hair, smiling
★★★★★

Dr Lee and the team at Northeast Facial are incredible. I was very nervous about my procedure but Dr Lee walked me through it step by step, never once making me feel rushed. Silvanna at the front desk went above and beyond to help me schedule an appointment that worked for me. I would highly recommend NEFOSS!

Stephanie Brown

★★★★★

“I had double jaw surgery done with Dr. Jacob in June 2021. I am extremely happy with my results. No more jaw pain and chewing problems. I also feel much more confident with my new smile. The surgery was definitely well worth it, thanks to Dr. Jacob and his team!”

Amelia Chen

★★★★★

“I would definitely recommend Dr. Jacob and his team at NEFOSS! Dr. Jacob and the team of doctors are very knowledgeable about all aspects of the TMJ process. They are such a nice group of doctors! The office staff is also very helpful and very friendly.”

Tiffany Puopolo

Frequently Asked Questions

Our advanced jaw surgery procedures are designed to enhance your quality of life. With a focus on precision and patient comfort, we ensure optimal results tailored to your unique needs.

Choosing Your Care Team

How important is experience in treating Condylar Hyperplasia?

Condylar Hyperplasia often involves complex surgical, developmental, and functional concerns that require coordinated, specialized management. Outcomes depend heavily on a surgeon's training, clinical judgment, and familiarity with the nuances of this condition. Teams that regularly treat patients with Condylar Hyperplasia are typically better equipped to manage both immediate surgical needs and long-term outcomes.

What is the difference between private practice and academic or hospital-based care?

In a private practice setting, care is often more streamlined and consistent, with the same surgeon closely involved in evaluation, treatment planning, surgery, and follow-up.

In academic or hospital-based settings, care may involve a larger team that can include residents or fellows participating under supervision. Both models can provide excellent care, but the structure and continuity of treatment may feel different. At our center, your care is delivered directly by your surgeon — not by residents, fellows, or surgeons in training.

Who will perform my surgery or procedure?

It is important to understand who is performing each part of your treatment. In some settings, the attending surgeon performs all critical portions of the procedure, while in others trainees may assist or participate under supervision. This should be discussed clearly in advance. At our center, your surgeon performs all critical portions of the procedure.

Will trainees be involved in my care?

Depending on the treatment setting, residents, fellows, or students may be involved in aspects of care. Patients and families should feel comfortable asking about their role and how care is supervised throughout treatment.

At our center, there are no residents or fellows involved in performing surgery.

Who will follow me after treatment or surgery?

Long-term follow-up is an important part of care for many conditions managed at our center. In some practices, post-treatment care may be shared among multiple providers, while in others the surgeon remains closely involved throughout recovery and monitoring. At our center, your surgeon personally follows you throughout recovery and long-term care.

How involved is the surgeon throughout the process?

Comprehensive care includes direct surgical involvement in evaluation, treatment planning, surgery, and long-term follow-up. Consistency throughout the process helps maintain continuity of care.

At our center, your surgeon is directly involved at every stage — from initial evaluation through treatment and follow-up.

Understanding Condylar Hyperplasia

What is condylar hyperplasia?

Condylar hyperplasia is a condition in which one or both of the jaw joints continues to grow beyond the normal period of facial development, causing progressive changes in the shape and alignment of the jaw. It most commonly affects one side, leading to a gradual shift of the jaw and bite to one side.

What causes condylar hyperplasia?

The exact cause is not fully understood. Condylar hyperplasia involves abnormal activity of growth cells within the condyle, the rounded upper portion of the lower jaw. It may occur in adolescents or young adults during periods of active growth. It is not caused by anything the patient did, and there is typically no identifiable external trigger.

What are the signs of condylar hyperplasia?

Signs may include a gradual shift of the chin and lower teeth away from the midline, asymmetry of the lower face and jaw, changes in the bite, and in some cases facial elongation on the affected side. The changes may be subtle initially and become more apparent over time.

How is condylar hyperplasia diagnosed?

Diagnosis involves clinical examination, dental and facial imaging including panoramic X-rays and CT scans, and often a nuclear medicine bone scan to assess whether the condyle is still actively growing. Identifying active versus arrested growth is important for treatment planning.

Does condylar hyperplasia always cause progressive worsening?

No. In many patients, abnormal condylar growth eventually slows and stops on its own. However, the degree of jaw and bite asymmetry that develops before growth arrests can vary and may require surgical correction.

Treatment Considerations

Does condylar hyperplasia always require surgery?

Not always. When the condition is mild or growth has arrested, observation or orthodontic management may be appropriate. Surgical treatment is considered when facial asymmetry is significant, the bite is functionally impaired, or active growth is confirmed and progression is expected.

What is condylectomy?

Condylectomy is a procedure in which the actively growing portion of the condyle is removed to stop further abnormal growth. It is typically recommended when bone scan imaging confirms active condylar growth. The procedure may be performed alone or in conjunction with corrective jaw surgery.

When is orthognathic surgery considered?

Once condylar growth has stabilized, orthognathic surgery to rebalance the jaws and correct the bite is often appropriate. Surgery is typically coordinated with orthodontic treatment and planned to address all dimensions of the facial asymmetry.

Can the facial asymmetry be fully corrected?

In many patients, a combination of condylectomy and jaw surgery can significantly improve facial symmetry and bite function. The degree of correction achievable depends on the severity of the deformity and the timing of treatment.

Long-Term Monitoring & Outcomes

Will the condition come back after treatment?

When treatment includes condylectomy to remove the actively growing tissue and growth is confirmed to have stopped, the risk of recurrence is low. Long-term monitoring of the jaw relationship and bite is still recommended after treatment.

What follow-up is needed?

Follow-up typically includes clinical examination and imaging at intervals to monitor jaw symmetry, bite stability, and joint health. Orthodontic retention and continued monitoring of the surgical outcome are part of long-term care.

Traveling & Out-Of-Town Patients

Do patients travel to your center for treatment?

Yes. We regularly care for patients traveling from outside the region for condylar hyperplasia evaluation and surgical treatment.

How long do patients typically need to stay near your center after surgery?

The local stay depends on which procedures are performed. For condylectomy alone, patients are typically discharged within one to two days and recovering well. Out-of-town patients should plan to remain locally for approximately five to seven days primarily to attend their first post-operative visit, where the surgeon confirms healing, jaw position, and early recovery before clearing travel home. When condylectomy is combined with orthognathic jaw surgery, the recovery involves a bit more monitoring and patients should plan for approximately seven to ten days locally before ground travel and approximately ten to fourteen days before flying, with the post-op visit serving as the key checkpoint before departure. These are general estimates — the specific timeline depends on the complexity of the surgery, recovery progress, and the distance of travel, and your surgeon will give you a clear recommendation in advance.

Is driving home different from flying?

Yes. Once the post-operative visit has taken place and the surgeon is satisfied with recovery, ground travel is generally approved shortly thereafter. Air travel is cleared somewhat later. Your surgeon will advise on both at or before the post-op visit.

What can patients expect during evaluation and treatment planning?

Evaluation at our center includes clinical examination, facial imaging, and bone scan interpretation to determine the activity of condylar growth. Patients receive a clear explanation of their diagnosis, where growth stands, and what the recommended treatment plan and surgical timing look like.

Will I need to return for additional visits after going home?

Yes. After returning home, continued follow-up is important to monitor jaw symmetry, bite stability, and the surgical result over time. Some visits may be conducted via telemedicine while imaging and in-person assessment visits will require a return to the center. Your surgeon will outline the follow-up plan before you travel home.

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