Redoing orthognathic surgery is possible, The scarring from the previous surgery can make it technically more challenging but the risks are essentially the same as the first time. Having orthognathic surgery a second time, although not common, is able to be done safely and with good results.
The key to success with orthognathic surgery lies in careful planning and preparation. This relies on a close cooperation between the surgeon and the orthodontist to ensure that the proposed movements are stable and result in a favourable outcome.
Moving the maxilla backwards is not done as it results in a loss of the normal facial contour, and the skin and soft tissue envelope around the jaws is too big and will sag. In short, it looks terrible.
Pre and postoperative orthodontics are essential to prepare for the surgery. The aim of this is to ensure the teeth are appropriately positioned over the base bone, and also to ensure that when the jaws are repositioned that the teeth then meet appropriately. Postoperatively orthodontics are required for a variable length of time to maintain the occlusion and to do any final 'finishing' that may be required.
Some centres have started doing surgery first orthognathic surgery, claiming a shorter period of orthodontics is required. However, those that do this even admit that it is only suitable for a small select group of patients. Our view is that doing this does not allow for careful and accurate planning and would lead to inferior results.
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