BSSO

Genioplasty requires precise surgical judgment, specialized training, and familiarity with the anatomical and functional nuances of this procedure. Outcomes depend heavily on the surgeon's experience, technique, and ability to anticipate and manage the full range of possible findings. Surgeons who perform this procedure regularly are typically better positioned to achieve consistent, safe results.

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.

It is important to understand who is performing each part of your procedure. In some settings, the attending surgeon performs all critical portions, 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.

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

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

Post-operative follow-up is an important part of surgical care. At our center, your surgeon personally follows you through recovery and any additional visits required.

At our center, your surgeon is directly involved at every stage — from the initial consultation and treatment planning through surgery, post-operative visits, and long-term follow-up.

A bilateral sagittal split osteotomy, or BSSO, is a surgical procedure that repositions the lower jaw by making precise cuts through the jawbone on both sides and moving the tooth-bearing segment forward, backward, or to a new vertical position. It is one of the most commonly performed jaw surgery procedures and is used to correct a wide range of lower jaw discrepancies.

BSSO is used to correct a lower jaw that is too far forward or too far back relative to the upper jaw, to improve bite function, to address facial asymmetry involving the lower jaw, and in some patients to help improve the airway. It is commonly performed in combination with upper jaw surgery and is frequently part of the surgical correction for sleep apnea.

BSSO may be performed as a standalone procedure when the lower jaw is the only jaw requiring correction, or as part of a double jaw surgery when both upper and lower jaws need to be repositioned. The decision depends on the patient's bite, facial profile, and treatment goals established through orthodontic and surgical planning.

Most patients undergoing BSSO will have completed a course of pre-surgical orthodontic treatment to align the teeth within each jaw before surgery. Orthodontic treatment continues after surgery to finalize the bite. The orthodontist and surgeon work closely together throughout the process.

Most patients today are not wired shut after jaw surgery. The bones are stabilized with small titanium plates and screws, allowing controlled jaw movement during recovery. Light elastic bands on the braces are typically used to guide the bite during healing, but these are far less restrictive than wiring.

The procedure is performed under general anesthesia through incisions inside the mouth. The surgeon makes carefully planned cuts through the lower jawbone on each side to allow the tooth-bearing portion to be moved to the planned position, where it is secured with titanium plates and screws. There are no external incisions or visible scars.

Swelling, jaw stiffness, and some numbness of the lower lip and chin are expected after surgery and gradually improve over weeks to months. A soft diet is required during the initial healing period. Most patients manage discomfort well and return to normal activities within a few weeks, though full bone healing takes several months.

Temporary numbness or altered sensation of the lower lip, chin, and teeth is very common after BSSO due to the proximity of the inferior alveolar nerve. In most patients this resolves over weeks to months. Some degree of permanent altered sensation is a recognized risk and is discussed thoroughly during the consent process.

BSSO produces lasting improvement in jaw position, bite function, and facial profile. Results are fully appreciated once post-operative swelling has resolved, typically over several months. Relapse is uncommon when surgery is well planned and healing proceeds normally, and the titanium fixation hardware typically remains in place without issue.

Yes. We regularly care for patients traveling from outside the region for genioplasty.

Most patients undergoing bilateral sagittal split osteotomy are discharged after one overnight stay and recovering well. Out-of-town patients should plan to remain locally for approximately one week primarily to attend their first post-operative visit, at which the surgeon examines healing, addresses any questions, and clears the patient for travel home.

Ground travel home is generally appropriate shortly after the first post-operative visit, once the surgeon has confirmed healing is on track. Air travel is generally cleared at approximately 5 to 7 days after surgery. Flying is approved somewhat later than driving because cabin pressure changes at altitude are a consideration during early healing. Your surgeon will confirm both clearances at the post-operative visit.

Yes. After returning home, a second follow-up visit will be needed to monitor continued healing and recovery. Depending on what needs to be assessed, this visit may be conducted via telemedicine or may require an in-person return visit. Your surgeon will advise on the format and timing of this follow-up before you travel home.

The consultation at our center includes a thorough clinical examination, review of any imaging or prior records, and a detailed discussion of the surgical plan, expected outcomes, recovery timeline, and what follow-up will involve. Patients leave with a clear understanding of the procedure and what to expect before, during, and after surgery.