I underwent double jaw surgery in February 2017 as part of an orthodontic treatment to fix my underbite, which lasted 2.5 years overall. In this article I will share my experience throughout the whole thing with you – from my reasons seek out treatment, the likely cause of my underbite, an overview of all the steps that the treatment consisted of and a detailed report on my recovery after the double jaw surgery – with lots of pictures of my progress and my final results.
I hope this article is helpful to anyone thinking about getting treatment or anyone currently going through it.
Disclaimer: I am not a medical professional and do not pretend to be one. I am simply sharing a personal experience of mine in this article. Please consult a medical professional for advice on any health problems that you might have.
For a large part of my life, I was often told that I look grumpy and kinda unapproachable. I never really knew why. Nobody in my family ever had braces. I was never send to an orthodontist by my parents, because it was never considered a necessity.
One day, when I was around 17 years old, a classmate casually mentioned that I had an underbite. Contrary to his assumption, that came as a surprise to me. I had what? Back then, I didn’t know what an underbite was. In fact, I actually had no clue how a correct bite was supposed to look like.
When I came home that day, I did some research and examined my own bite and BAM, sure enough, I had an underbite. Knowing that about myself certainly didn’t exactly help with my confidence, but I have not yet experienced physical discomfort because of my misaligned jaw at that point
This started to change a couple of years later. The underbite got worse and my teeth starting chipping off because they kept hitting each other at an increasingly awkward angle. I started getting gaps between my teeth. My jaw joint started making noises when I opened my mouth wide. Popping, clicking and my jaw almost locking in place became a regular occurence. My teeth fit less and less together. I grew increasingly frustrated. For many years, I spend a large part of the day pushing my lower jaw back and forth trying to find a comfortable position without success.
I started looking into treatment options. I consulted several orthodontists and they all confirmed the same thing: I had an underbite. An orthodontic treatment and jaw surgery was required to fix it.
My environment was not supportive of me seeking treatment at all. I was told that I was too vain (“You’re pretty enough!”), imagining problems where there are none – gullible for believing the orthodontists’ lies who just want to earn a buck, stupid for risking everything and considering such an incredibly dangerous surgery because of an nonexistent flaw.
All of this feedback, plus the fear of looking stupid as an adult with braces, held me back from doing anything about my underbite for many years. My husband, who I have met when I was 23, was actually the first person who supported me in my wish to get my underbite treated, even though he himself didn’t notice it before I pointed it out. His support, combined with the growing discomfort I was feeling, made me finally push through my fear after 10 years of letting the underbite bother me.
I started an orthodontic treatment to fix my underbite when I was 27.
Before the actual treatment started, my orthodontist was looking to find out why I had the underbite to begin with. Nobody in my family had an underbite, so genetics was not really a probable cause. During my first appointment, my orthodontist asked me to bite down (as pictured above) and then swallow. I didn’t really know what the point was back then, but swallowed anyway. With my tongue pushing against my lower teeth, as always. Not the way you are supposed to swallow? Well, I had no idea I was doing anything wrong until this moment. Turns out, you are supposed to push your tongue into the roof of your mouth when you swallow. During the same appointment, I tried to do just that but it felt absolutely impossible!
With lots and lots of exercising every day I managed to change my swallowing technique successfully. My orthodontist strongly suspects that the swallowing issue has caused my underbite, so I hope that I won’t suffer a relapse now that I have corrected it.
After the introduction of a proper swallowing technique, my orthodontic treatment started with the expansion of my upper palate. This was achieved with a device called the palatal expander. I had no idea that my upper palate was too narrow at that time, so it didn’t seem to me that I needed one. Boy, was I wrong! I am in awe of the before and after pictures and became a total believer in the importance of orthodontic health. My orthodontic treatment came with many revelations and the miracle that a palatal expander can work on you was the first.
These were my results after wearing the palatal expander full time for 3.5 months! You can read about my experience with the palatal expander in more detail here.
In May 2016 I got braces. It didn’t look as bad as I feared at all, but I struggled with quite a lot of discomfort in the first weeks after getting the braces in.
My teeth were sore to the point where it was hard to eat and I started developing sores in my mouth from the friction. At the beginning, I therefore used a lot of orthodontic wax to cover the brackets. I couldn’t imagine it possible at that point, but somehow my mouth healed and I stopped developing sores pretty soon.
Besides the braces, I also had to wear elastics and chains to guide my teeth into certain directions. The elastics were probably the worst in terms of pain, since they exert quite a lot of force. You can read about my experience with adult braces in more detail here.
Results pre double jaw surgery
After about a month, I was used to the braces. Pain was minimal and I kept seeing more and more adults with braces, which was encouraging.
My underbite however got a lot more pronounced. I believe that this is because my teeth were tilted before the treatment. When the braces started to straighten my teeth out, a huge gap formed between by upper and lower teeth.
In the months before the jaw surgery my bite was so bad that I got really impatient to get the surgery done. Chewing was even more challenging than before with the gap in the front. Looking at photos of myself was even worse. I often dreamt that I had the surgery behind me and then woke up very dissappointed.
Double jaw surgery
On February 21st 2017, the day of the surgery finally came. I was so anxious that I could absolutely not sleep. I checked into the hospital the day before and asked for sleeping pills which ended up having no effect whatsover. Luckily, I got some strong relaxation meds a couple of hours before the surgery, so that my anxiety levels finally went down and I slumbered away. It must have been some strong stuff since I can’t remember being rolled into the surgery room or getting anesthesia.
Day 0 – Pain, nausea, numbness
I woke up in the evening, super emotional and overwhelmed with relief. For some reason, I was convinced that there was a 50% chance that I will not make it through the surgery. Yet here I was, ALIVE. I grabbed my phone next to my bed and switched on the front camera. Underbite gone. I could barely move my face, but I was bursting out laughing in my head. This was surreal. I felt and looked pretty beaten up, but I was so happy to finally be on the other side. All this waiting, worrying, anticipating was finally over.
The worst part of course was not. Now the recovery began. Thankfully, I was always given sufficient amounts of pain killers, so I was never really in pain. However, as the anesthesia wore off, I was getting more aware of my body. A splint was inserted in my mouth and my teeth were held in place firmly by the toughest rubber bands I have ever come across. A lot of my face was numb (mostly around my nose and upper lip), I already was a bit swollen and the worst at this point – I felt incredibly nauseous.
When a nurse came by and asked me to get up to get my circulation going, I almost fainted. I sat back down on my bed quickly and an extremely intense wave of nausea came over me. I started puking huge amounts of dark red blood that reeked of disinfectant. Since my teeth were shut and I had a splint in, the blood just kinda bubbled out from inbetween the few cracks and gaps I had in my mouth. Once I was done puking, I felt a lot better and the nausea disappeared soon thereafter.
Day 1 & 2 – Swelling & breathing problems
The swelling increased rapidly though and this is where things started to get real uncomfortable. The swelling in my face made my skin feel very tense, but that was totally bearable compared to the swelling inside my nasal cavity and my throat. For some reason I had a bad case of swelling inside my airways, making it super hard to breathe. My nose completely clogged up at around 36 hours after surgery. I got a nose spray that was supposed to help with that, but it always only worked for maximum 10 minutes and only very slightly. Besides the swelling, I had so much mucus and blood clots coming out of my nose. After the double jaw surgery, you are not allowed to blow your nose, so I had an incredibly hard time with all the gunk in my nose. I got a tip from a nurse at some point to snort downwards and then swallow. This was quite gross, but safed me from drowing in my own snot.
Day 3 – The worst
Around 72 hours after the double jaw surgery the swelling inside my throat reached it’s peak. This was really scary, since breathing through my mouth was my (literal) lifesaver with a clogged nose. It was already difficult enough since my teeth were wired shut – seriously, I sounded like Darth Vader – but having a completely closed throat was not an option I could live with (ha). The thought of suffocating was incredibly scary to me and I was in a state of panic for around 24 hours until the swelling finally showed signs of receding.
I have done a lot of research before I had double jaw surgery and read endless amounts of reports from others who survived the experience, but the severity of the breathing difficulties took me by surprise. Day 3 was truly tough and I kept sipping on cold water, trying to breathe, walking around breathing fresh, cold air, telling myself that this is temporary and I WILL make it through this.
Day 4 – Finally, improvement!
And you guessed it, I did make it through. My throat never closed and the panic probably contributed to the feeling of tightness more than the swelling itself. The swelling started to go down at the end of day 4 and everything became so much easier from there on. I regained my appetite after days of mostly just drinking water and I finally took a shower. I had my first protein shakes, chocolate milk and some soup.
After going through days that felt like months, time finally normalized. Being alive was bearable again and it was quite fun to wake up a bit less swollen every day. I got released from the hospital a week after the double jaw surgery.
Day 8 – Finally home
I was happy to have nurses and doctors around me during the worst days, but being home was amazing. I had my husband around me all the time again and could sleep in my own bed, open the window and take a walk whenever I wanted, eat what and whenever I wanted – and the best: chill in the bathtub. My cat was very weirded out by me first – she followed me from room to room from a safe distance, keeping her eyes at me at all times :D. She went back to normal a few days later though.
I completely overestimated though how fast I could get started with doing even basic chores. Very simple things were incredible exhausting – like talking, cleaning or grocery shopping. You really have to plan in a couple of weeks of recovery after such a surgery, preferably a month.
Day 13 – Stitches
2 weeks after the double jaw surgery the stitches were supposed to be pulled. I couldn’t wait for them to be removed since my mouth felt very stiff with them in. With the swelling and the numbness decreasing I was a lot quicker to move my face than in the first days after the surgery – only to regret it immediately every single time. Especially laughing was very painful. The place around my lip frenulum became increasingly irritated and on day 13 post surgery I woke up to blood & clear liquid running down my teeth. I panicked and immediately went back to the hospital.
Luckily, they ensured me that there was no infection. Sometimes the body can’t work out all the liquids that accumulate around a wound, but the wound has to burst at the surface for the liquid to drain. While I was there, they removed the stitches so that I didn’t have to come back the next day. The hole that developed from the burst just grew back together and I didn’t need any more stitches.
Day 21 – Getting the splint out
3 weeks post surgery I finally got the splint out at the orthodontist office. What a disgusting and amazing experience that was! I finally could feel my new mouth and run my tongue along my new bite. It was quite gross since I couldn’t really brush my teeth for 3 weeks but also so incredibly spacey! I felt like I had twice as much space for my tongue at my upper palate.
My bite after double jaw surgery
My bite was far from perfect though. My teeth basically just touched in the front. One the right side, there was only a little gap between my upper and lower teeth, but on the left side there was around 1 cm. Chewing would have been almost impossible with that bite. Since I had to be on a liquid diet for 2 months this was not too problematic though – no chewing happening anyway.
Opening my mouth after double jaw surgery
I could barely open my mouth at three weeks post double jaws surgery (around 1cm), but I was told that that was normal. As long as I could open my mouth 1cm more each month until I reach 4cm after 4 months, there is nothing to worry about and no exercises are necessary. This is also exactly how it ended up going for me. It just came back naturally to me and I can open my mouth fully today.
The orthodontic treatment continues
My orthodontic treatment continued right away. I started to wear some tough elastics to force my teeth closer together. Since a lot of orthodontic treatment was necessary to make my teeth touch, I was not really able to chew properly when I was finally allowed to 2 months after the surgery.
Chewing after double jaw surgery
Not being able to chew properly even after I got the green light to eat solids again was quite frustrating since I was soooo sick of soups and shakes. I really missed the CRONCH. At around 3 months post surgery my teeth on the right side finally were close enough so that I could use that side to chew. It worked better and better with every passing day, but I noticed that after chewing tough things like salad for a long time, my jaw joint on the right side would start jumping from postition to position in a not so smooth way when I opened and closed my mouth. This happened less and less as time went on though and luckily disappeared completely at some point.
Over the next months, any remaining swelling (the worst was gone after around 4 weeks) went away very slowly.
Swelling development after double jaw surgery
Here are as couple of selfies illustrating the development of the swelling after the double jaw surgery:
6 months post double jaw surgery – almost back to normal
After 6 months, the swelling was completely gone and my bite was good enough to chew on both sides. The only numbness that remained, was around parts of my upper gums. Weirdly, just next to numb areas, were incredibly sensitive areas – just above my upper canines. This sensitivity was really the only negative effect that remained post double jaw surgery. Especially when I brushed my teeth I experienced pain when I would go over the area. Weirdly, the pain shot up my nose as well, where some of the plates & screws must have been.
It was a minor inconvenience compared to the great benefits I got out of surgery & the orthodotic treatment though.
Plate removal surgery
Just after 6 months and one week after the double jaw surgery, I got the plates and screws removed in a second surgery. This is done routinely in Germany (where I lived at that point) and not just in case of complications.
I had a very quick and easy recovery after the plate removal surgery compared to the double jaw surgery and the benefits were noticable almost right away – my sensitivity issues decreased notably and I feel I am a little bit less puffy around the nose with the plates gone. Best of all though, it feels amazing to know that there are no foreign objects attached to my skull.
You can read about my experience with the plate removal surgery in more detail here.
Getting the braces off!
In November of 2017, 9 months after my double jaw surgery and 3 months after the plate removal, I got my braces off. Getting them off was quite a quick and painless procedure – and seeing the result of this long journey reveal itself in a matter of minutes was breathtaking. I couldn’t stop smiling and staring at my teeth in the mirror.
After getting my braces off, I had to wear a removable retainer for 6 months to make sure that my teeth stay in place. Dealing with the retainer was a similar experience as when I wore the palatal expander, except that I had to wear one on both my upper and lower teeth. Being so used to all kinds of orthodontic equipment by now though, I thought it was quite easy to handle and time went by rather fast at this stage.
As the very last step of my orthodontic treatment, I got a permanent retainer installed, which is basically just a thin wire glued to the back of your teeth. It limits your ability to floss, but the benefit of preserving your results is very much worth the inconvenience in my opinion.
My final results
After 2.5 years of orthodontic treatment involving a palatal expander, 1.5 years of braces and double jaw surgery in the middle of it all, I can proudly present these before and after pictures:
I am so happy with the results and even though it was a lot of discomfort, it was so so worth it and I’m happy I went for it.
I still have some numbness/sensitity around my gums, but otherwise, on most days, I tend to forget that I ever went through this and ever had an underbite to begin with.