Upper jaw (maxillary) surgery
Planned surgery to cut and reposition the upper jaw (a Le Fort I osteotomy), moving it to correct the bite and facial balance, almost always combined with a long course of braces.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It cuts and repositions the upper jaw (a Le Fort I osteotomy) to correct the bite, and is almost always combined with a long course of braces before and after.
- Numbness of the upper lip, cheek and gums is common afterwards; it usually recovers over weeks but can occasionally be permanent.
- It is a major operation under general anaesthetic, with about 3–6 weeks off and a soft diet for several weeks.
- It is available on the NHS for recognised functional problems; results cannot be guaranteed and larger movements carry more relapse risk.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Corrects a bite that braces alone cannot fix
The bite can be corrected by orthodontics (braces) alone without moving the jaw bone.
Swelling and bruising of the jaw, mouth and nose build up; you are on liquids with pain relief and anti-sickness medicines. Most people go home after 1–2...
Joint follow-up by both the surgeon and the orthodontist over the months after surgery.
Swelling and bruising of the jaw, mouth and nose build up; you are on liquids with pain relief and anti-sickness...
Most swelling settles, though the nose may feel blocked. You continue a soft or liquid diet and keep the mouth...
Many people return to work or study and to normal food. Upper-lip numbness and some swelling, especially at the...
Sensation gradually improves and nose-base swelling reduces. Braces stay on for around six months to finish the...
What is upper jaw (maxillary) surgery?
Upper jaw surgery, or maxillary osteotomy, repositions the upper jaw to correct the bite and the balance of the face. The usual technique is a Le Fort I osteotomy, where the upper jaw is separated above the teeth so it can be moved up, down, forward or back, then fixed with small plates and screws.
Like all jaw realignment surgery, it is part of a long pathway run jointly by an orthodontist and a maxillofacial surgeon. Braces line the teeth up for many months before the operation and continue for around six months afterwards to settle the bite.
It is done mainly to correct a bite that braces alone cannot fix, to improve chewing, sometimes breathing or the amount of gum or tooth on show, and to improve facial balance. It does not give a guaranteed cosmetic result.
Numbness of the upper lip, cheek and gums afterwards is common because nerves run close to where the bone is cut. This usually recovers over weeks, though occasionally it can be longer-lasting or permanent. The base of the nose can also stay a little swollen for some months.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Upper jaw surgery vs braces alone
| Option | What it can do |
|---|---|
| Braces alone | Move teeth within the jaw; cannot reposition the jaw bone |
| Upper jaw surgery | Moves the whole upper jaw to correct the bite and gum/tooth show |
| Sinus/nose consideration | The jaw sits near the sinuses and nose, which can swell or feel blocked early |
| Time involved | Long braces pathway plus a major operation and recovery |
Your orthodontist and surgeon will explain whether your bite genuinely needs the jaw moved, or can be corrected by braces alone.
Preparing for your surgery
- Have a joint assessment with an orthodontist and maxillofacial surgeon, with X-rays, scans, photos and tooth models.
- Expect braces for many months before surgery to line up the teeth (which can temporarily worsen the bite).
- Stop smoking well beforehand, as it impairs bone healing.
- Tell the team your full medical history and all medicines, and complete any pre-operative checks.
- Plan for 3–6 weeks off and a liquid then soft diet for several weeks.
- Arrange a lift home and help for the first days, and protect time for follow-up appointments.
- Ask what the surgery will and will not change about your smile, gum show and profile before you consent.
What happens
The operation is done under general anaesthetic and usually takes around one and a half to three hours. The surgeon works through cuts inside the mouth above the teeth, so there are normally no cuts on the face.
The upper jaw is carefully separated (the Le Fort I cut), moved into its planned position, and fixed with small titanium plates and screws. A guide (a splint) and elastic bands on the braces help set the bite. Because the jaw sits next to the sinuses and nose, the nose can feel blocked and the base of the nose can stay swollen for a while.
Most people stay in hospital for one or two nights. Swelling and bruising of the jaw, mouth and nose peak around the second or third day. You start on liquids, progress to soft foods, and return to a normal diet over about four to six weeks.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The bite can be corrected by orthodontics (braces) alone without moving the jaw bone.
- The person cannot commit to the long orthodontic treatment before and after surgery.
- Active gum disease, decay or poor oral hygiene that must be treated first.
- A medical condition or smoking habit that makes major surgery or bone healing unsafe.
- Mainly cosmetic or unrealistic expectations not matched by the likely result.
Delay surgery if…
- Facial growth is not yet complete (surgery is usually deferred until growth has finished).
- Gum disease, decay or poor oral hygiene need treating first.
- There is active sinus infection that should settle before surgery.
- You are pregnant or planning pregnancy in the near term, or smoking has not been stopped.
- The pre-surgical orthodontic alignment is not yet complete.
Alternatives to discuss
- Orthodontics alone where the problem allows.
- Camouflage orthodontics for a mild discrepancy without surgery.
- Restorative or cosmetic dentistry, or gum treatment for a gummy smile, in selected cases.
- Accepting the current bite if symptoms are mild and function is acceptable.
- An NHS pathway rather than private treatment.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Corrects a bite that braces alone cannot fix
- Can make chewing and biting more effective and comfortable
- Can reduce a 'gummy' smile or correct the amount of tooth on show
- Can help with some breathing problems in selected people
- Improves the balance of the mid-face, and is stable and long-lasting in most people
Risks & complications
- Swelling and bruising of the jaw, mouth and nose, worst around day 2–3
- Numbness of the upper lip, cheek and gums (common early on)
- A blocked or congested nose for a time, and a soft or liquid diet for several weeks
- Tiredness and disruption for several weeks
- Numbness that lasts several weeks before recovering
- The bite not being quite right, sometimes needing a small further operation
- Plates becoming infected and needing removal, usually months later
- Some relapse, where the jaw drifts slightly from its new position
- A small amount of nosebleeding, or a change in the shape of the nose tip or nostrils
- Numbness of the upper lip or gum lasting more than a year and possibly permanent
- Heavy bleeding during or after surgery
- Problems with blood supply to a segment of jaw or to teeth (rare)
- A blood clot in the leg or lung, chest infection or other general anaesthetic complications
The upper jaw sits next to the sinuses, nose and several nerves, so early numbness of the upper lip and cheek and a blocked nose are common, and the base of the nose can stay swollen for months. Most numbness recovers, but it can occasionally be permanent. Larger movements carry more relapse risk, and the shape of the nose can change subtly. Ask your surgeon how your nose and smile may be affected, your personal numbness risk, and how the bite will be checked.
Published figures to discuss
Reported nerve-injury and relapse rates after Le Fort I surgery vary between studies because sensation is measured differently and outcomes depend on how far and in which direction the jaw is moved. Most numbness of the upper lip and cheek recovers within weeks to a couple of months. Movements such as widening or bringing the jaw downward are less stable. The figures below are broad indicators for discussion.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Altered upper-lip/cheek/gum sensation early after surgery | Common initially; one recent review reported about 94% recovery of infraorbital-nerve disturbance by 6 months | Per NHS and surgical patient information; a small proportion have longer-lasting change. | Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgerycuh.nhs.ukPublished figure |
| Altered sensation lasting more than a year / possibly permanent | Uncommon | Reported less often than for lower-jaw surgery; discuss your own risk with your surgeon. | Le Fort osteotomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govSource-linked context |
| Need for a small further operation to adjust the bite/plates | Uncommon ('rarely') | Per NHS patient information; the bite is checked and corrected if not quite right. | Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgerycuh.nhs.ukSource-linked context |
| Relapse with less stable movements | More likely with downward or widening movements than with simple advancement/impaction; measurable relapse is commoner than clinically important relapse | Exact rates vary; managed with planning, fixation and orthodontic retention. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery takes weeks for everyday life but months for full settling. Swelling, a blocked nose, altered sensation and a restricted diet are expected early on, and the orthodontic part continues after the operation.
- Swelling and bruising of the jaw, mouth and nose in the first two weeks
- A blocked or congested nose for a time after surgery
- Numbness of the upper lip, cheek and gums, improving over weeks
- A soft or liquid diet for several weeks before normal food returns
- Subtle swelling at the base of the nose that can take months to settle
Aftercare
- Take pain relief and any anti-sickness or antibiotic medicines as prescribed.
- Keep to the recommended liquid then soft diet and stay well hydrated.
- Keep your mouth scrupulously clean with gentle brushing and any prescribed mouthwash.
- Sleep with your head raised and use cold packs early to ease swelling.
- Avoid blowing your nose hard, and follow advice on sneezing with your mouth open, while the sinus area heals.
- Avoid smoking, strenuous activity and contact sport as advised.
- Wear elastic bands on the braces as instructed and attend all surgeon and orthodontist appointments.
- Soft and liquid foods and nutritious drinks at home
- Prescribed painkillers, anti-sickness and any antibiotics collected
- A soft toothbrush and any prescribed mouthwash
- Extra pillows and cold packs
- Time off work or study booked (about 3–6 weeks)
- Someone to collect you and help for the first days
- The surgical team's contact number for problems
Scars and how they heal
Upper jaw surgery is done through cuts inside the mouth above the teeth, so there are normally no visible scars on the face. The titanium plates and screws stay in the bone and are not usually felt. The shape of the nose tip or nostrils can change a little because the jaw sits beneath the nose.
⚠ Get urgent help if…
- Difficulty breathing or swallowing — seek urgent help
- Heavy bleeding from the mouth or nose that will not stop
- Spreading swelling, redness or pus with fever (possible infection)
- A hot, swollen or painful calf, or sudden chest pain or breathlessness (possible clot) — seek urgent help
- A sudden change in how your teeth meet, or a feeling the jaw has shifted
- Numbness that is worsening rather than slowly improving
- Fluid or air passing oddly between the mouth and nose, or persistent nosebleeds
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the teeth meet correctly, chewing is comfortable, the smile and gum show are improved as planned, and the mid-face is better balanced, with the bite finished by the braces. This is judged over many months as swelling settles and the orthodontics is completed.
Surgery cannot promise a precise cosmetic outcome or that feeling will fully return, and the nose shape can change subtly. A small amount of relapse can occur, particularly after large movements.
For most people the corrected bite and jaw position are stable and long-lasting once healing and orthodontics are complete, helped by wearing retainers. Some relapse is more likely after large movements such as bringing the jaw down or widening it. Titanium plates usually stay in permanently and only occasionally need removing.
Combining with other procedures
Upper jaw surgery is combined with orthodontic treatment before and after the operation, and is often done alongside lower jaw surgery (two-jaw surgery) or chin surgery for more complex problems. Your team will explain how these fit together for your case.
Follow-up & long-term care
You will be reviewed before discharge and then jointly by your surgeon and orthodontist over the following months, often for up to two years, checking healing, the bite, recovery of sensation, the nose and the orthodontics. Report breathing difficulty, heavy bleeding, signs of a clot or a sudden change in your bite straight away.
- Wear retainers after the braces come off, as long as advised, to hold the result.
- Keep up excellent oral hygiene and regular dental and orthodontic reviews.
- Tell your team if numbness worsens or your bite changes after treatment.
- Plates are usually left in place; report any plate that becomes tender or infected.
Revision and secondary surgery reality
- Occasionally a second, smaller operation is needed to fine-tune the bite or reposition plates.
- Some relapse can occur, especially with less stable movements, needing orthodontic or rarely surgical management.
- Plates are usually left in but can be removed later if they become infected or troublesome.
- The final result, including nose-base swelling, is judged over many months once swelling settles.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Joint follow-up by both the surgeon and the orthodontist over the months after surgery.
- Clear written instructions on diet, mouth and sinus care, medicines and warning signs, with a named contact.
- A plan to check the bite and to act if it is not quite right.
- Honest tracking of sensation recovery and nose-base swelling, with onward advice if numbness persists.
- Retainer and long-term orthodontic plan to hold the result and limit relapse.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the upper jaw alone, or the lower jaw and/or chin too, are operated on
- The length and complexity of the operation and the surgeon's and anaesthetist's fees
- Theatre time and length of hospital stay
- The long orthodontic treatment before and after surgery (often a separate, substantial cost)
- Imaging, 3D planning, surgical guides, plates and screws
- Follow-up appointments with both surgeon and orthodontist over up to two years
- Any further surgery to adjust the bite or remove plates
- The surgeon's and anaesthetist's fees and theatre/hospital costs
- The full orthodontic cost before and after surgery, and who provides it
- Imaging, 3D planning and the cost of plates, screws and surgical guides
- The expected number of nights in hospital
- All follow-up reviews with the surgeon and orthodontist
- What happens, and what it costs, if the bite needs adjusting or plates need removing
- The cancellation policy and what is included if a complication occurs
On the NHS? Upper jaw surgery is available on the NHS when there is a recognised functional need that meets local criteria; requests for purely cosmetic reasons are usually private.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that the nose shape can change because the jaw sits beneath it.
- Underplaying early numbness of the upper lip and cheek, and that it can occasionally be permanent.
- Not making clear how long the whole orthodontic-plus-surgery pathway takes.
- Presenting it mainly as a cosmetic procedure with a guaranteed look.
- No clear plan, or cost on the private pathway, for adjusting the bite or removing plates if needed.
Marketing red flags
- Marketing upper jaw surgery mainly as a cosmetic mid-face or smile enhancement.
- Promising a precise, guaranteed facial or smile result.
- Downplaying the long braces pathway, nose changes or temporary numbness.
- Not mentioning that numbness can occasionally be permanent.
- Offering surgery before facial growth is complete in younger patients.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Which way will my upper jaw be moved, and how will that affect my smile and gum show?
- How might my nose shape change, and how is that managed?
- What is my personal risk of lasting upper-lip and gum numbness?
- How long will I be in braces before and after the operation?
- How will you check my bite afterwards, and what if it is not quite right?
- Will the lower jaw or chin be operated on at the same time?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
What is a Le Fort I osteotomy?
Will my nose change shape?
Will my upper lip be numb afterwards?
Can I have it on the NHS?
Why is my nose blocked after surgery?
How long is the recovery?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgery University Hospitals Plymouth NHS Trust — Orthognathic surgery Maxfacts (UK OMFS patient information) — Jaw disproportion Le Fort osteotomy — StatPearls (NCBI Bookshelf) BAOMS — What is Oral & Maxillofacial Surgery Neurosensory disturbance after orthognathic surgery — PMC Orthognathic surgery and relapse — systematic review
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Jaw realignment surgery (orthognathic surgery) · Lower jaw (mandibular) surgery · Treatment of jaw joint disorder (TMJ / TMD) · Cheekbone fracture repair · Cleft lip and palate surgery