Surgery
Double Jaw Surgery (Bimax)
The only intervention that genuinely rebuilds the middle and lower thirds of the face. Major surgery, 12–24 months of orthodontics around it, and a real complication profile.
Also called: bimax · orthognathic surgery · double jaw · lefort 1 · bsso
Verdict — legit
Does what it claims, with evidence behind it.
Evidence grade B
At least one good randomised trial, or consistent findings across controlled studies.
Mechanism
Le Fort I osteotomy repositions the maxilla and a bilateral sagittal split osteotomy repositions the mandible; counter-clockwise rotation additionally changes chin projection and airway volume.
Citations
- Maxillomandibular advancement for obstructive sleep apnea: a meta-analysisSleep Medicine Reviews · 2016
- Neurosensory disturbance following bilateral sagittal split osteotomy: a long-term follow-upJournal of Cranio-Maxillofacial Surgery · 2019
The full read
This is the operation behind most of the dramatic transformations circulating in this community, and it is a functional procedure that happens to be transformative — indicated for malocclusion, facial asymmetry and obstructive sleep apnoea, with airway outcomes that are among the strongest in surgery. What the before-and-afters omit: 12–24 months of pre- and post-surgical orthodontics, a hospital stay, weeks on a modified diet, and inferior alveolar nerve disturbance that is common initially and permanent in a minority. Relapse occurs in some movements. It is the right answer for a genuine skeletal discrepancy and a very wrong one for a cosmetic wish with a normal bite — and a surgeon will say so.