About 1 in 3 patients with cleft lip and palate benefit from jaw surgery.
Aligning the upper and lower teeth helps people to fully chew food, to speak clearly, and to reduce wear and tear on the TMJ's.
We also consider facial balance and harmony when planning the surgery and final outcome.
Jaw surgery can often be done in a single surgery, sometimes involving just the upper jaw, and sometimes with the lower jaw as well.
Here, the amount of advancement was well over 10mm, which is the point at which we usually move towards distraction rather than a single surgery.
Distraction involves cutting the bone and freeing up scar tissue, but then gradually moving from the starting position by 1mm per day to reach the end goal.
New bone is deposited in the space made as the upper jaw moves forward. The surrounding blood vessels, lining, and old scar tissue all expand and accommodate the new bony position.
We usually keep the hardware in place (much more comfortably after finishing advancement!) for 3 months while the new bone hardens.
At that point, minor adjustments can be made as needed with additional movement or augmentation, or just removal of the hardware.
We also performed some fat grafting to the upper lip to help with balance and symmetry.
He is seen here at 1 year after surgery, with braces off!