What is bimaxillary (Bimax for short) surgery?

During bimaxillary surgery, the surgeon operates on both jaws – the lower and the upper – in a single procedure. This allows for the greatest change in facial aesthetics and bite function, since both jaws can be moved or tilted in any direction in space.

Compared with single-jaw procedures, the recovery time is slightly longer and the operation is more complex; at the same time, the achievable result is far more striking: a harmonious smile, a more symmetrical face, and easier biting and breathing.

When might Bimax surgery be needed?

It is most often recommended when the problem can no longer be corrected with orthodontics alone, for example:

a severe jaw discrepancy (Class II or Class III bite),
when the lower jaw sits ahead of the upper jaw (Class III),
when the upper jaw is too narrow or set too far back,
when the aesthetics of the smile and face can only be improved through complex jaw repositioning.

The structure of bimaxillary surgery

Bimax surgery actually consists of two separate procedures, which the surgeon performs in a single session.

1. BSSO – Bilateral Sagittal Split Osteotomy

This is the operation on the lower jaw. The surgeon splits the bone behind the last teeth, then moves it into the pre-planned position and fixes it with titanium screws.

Most often we achieve the desired result by advancing the jaw forward.
The profile improves: the chin comes forward, the double chin is reduced, and the contours of the face become sharper.
Closing the mouth becomes easier, and the outward turning of the lower lip can disappear.

2. Le Fort I osteotomy

This is the operation on the upper jaw. At the level of the nasal floor we detach the bone block that holds the teeth and the palate, then position it as desired and fix it with small titanium plates.

The incision is always made inside the mouth, so there are no external scars.
The plates and screws remain in place permanently and do not need to be removed.
By repositioning the upper jaw, not only the bite can be improved, but nasal breathing can also become freer.

Recovery and what to know after surgery

The surgery is performed under general anaesthesia in a hospital setting, usually with a 2-night stay.
Healing takes 2–3 weeks: stronger swelling may appear in the first days, but it subsides quickly.
Physical rest is needed for 3 weeks, and contact sports should be avoided for about 3 months.
The pain is usually moderate; many patients describe it as easier than wisdom-tooth surgery.
The most common temporary side effect is numbness in the chin and lips, which gradually eases within weeks.
The surgery takes place at roughly 2/3 of the entire orthodontic process; the appliance stays on throughout, and treatment continues after the surgery.
If desired, a chin plasty (genioplasty) can also be performed at the same time as the surgery.

Class III Bimax surgery – a special case

“Class III” means that the lower jaw sits ahead of the upper jaw. In such cases, during Bimax surgery:

the BSSO involves more of a tilting, rotating movement, in order to avoid narrowing the airway,
it is often combined with a chin plasty if the chin protrudes excessively,
the Le Fort I upper-jaw repositioning ensures an aesthetic and harmonious result.

In summary

Bimaxillary surgery is one of the most effective and comprehensive procedures for treating jaw discrepancies and severe bite problems. Although recovery is a little longer, the result is lasting and striking from both a functional and an aesthetic point of view.

The precise treatment plan and the surgical options are determined in every case during a personal consultation. The detailed information, as well as the costs, will be explained by our surgeon, Dr. Krisztián Nagy.