The term orthognathic means "straight jaw." Orthognathic surgery is usually performed in a hospital by an oral and maxillofacial surgeon. Typically, the surgeon makes incisions from inside the mouth and cheeks so that there are no scars on the face. In cosmetic oral and maxillofacial surgery, which addresses the soft tissue drape of the face, incisions are sometimes made on the facial skin itself.
Cuts in the bone, or osteotomies, are made with specially designed instruments. The bones are then properly rearranged and wired internally for several weeks so that the parts can "set" in their new positions. In some cases, stainless steel wires are left in position. Occasionally the surgeon will correct bony problems and may even perform surgery on the nasal passages, eyelids, cheeks or chin.
Another approach to orthognathic surgery involves the use of internal rigid fixation, in which screws and plates are used instead of wires, or are used in addition to them. This often allows the patient to regain jaw mobility more quickly. In such cases, small incisions in the skin may be necessary.