Yale Maxillofacial and Orthognathic Surgery Program

The Yale Maxillofacial and Orthognathic Surgery Program has one of the most comprehensive and most respected treatment programs in the nation.

Our goal is to alleviate symptoms of maxillofacial discrepancies to maximize patients' ability to speak, eat, and chew; to alleviate breathing problems; and to minimize TMJ pain and the potential for sleep apnea. We also focus on improving appearance and facial symmetry by balancing the face and jaw ratio.

During the surgical planning stage, we strive to use the most sophisticated 3D imaging tools available. With 3D photo imaging, 3D CT scan imaging, and special software programs, we can simulate proposed outcomes so that patients can see the results before surgery.

If a patient has jaw deficiencies or protrusions due to birth defects or other reasons, a bilateral sagittal split osteotomy can be used to move the jaw forward or backward.

By using advanced 3D imaging to assess the patient's specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

Genioplasty refers to a chin augmentation with chin implants or sliding genioplasty. A genioplasty can help if the patient has abnormalities of the chin due to conditions such as hemifacial microsomia, or if patients would like to enhance their facial symmetry by increasing the size and projection of their chin.

The two main types are sliding genioplasty and chin implants.

Chin implants are used for minor abnormalities and to balance symmetry due to a disproportionate chin, while sliding genioplasty is used to treat more complex deformities due to birth defects or trauma, such as straightening deviated and twisted chins.

Through genioplasty, the faculty at the Yale Maxillofacial and Orthognathic Surgery Program correct abnormalities of the chin due to congenital defects, trauma, or disease. The result is a more balanced chin position, enhanced facial symmetry, and improved airway function. Our faculty work together with the patient's orthodontist; if they do not have one, we can refer a trusted specialist.

By using advanced 3D imaging to assess the patient's specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

If the patient has malocclusion (the misalignment of teeth and jaw) due to cleft palate, midface hypoplasia (underdeveloped upper jaw, cheekbones, nose, and eye sockets), and other upper jaw issues, a Le Fort osteotomy is often the treatment of choice. Le Fort osteotomy is upper jaw surgery that involves sectioning and repositioning the maxilla, or upper jaw, to correct its abnormal position. 

By using advanced 3D imaging to assess the patient’s specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology. 

The Yale Maxillofacial and Orthognathic Surgery Program, which includes maxillofacial surgeons and specialists from 18 clinical services, corrects abnormalities of the upper jaw to provide better balance of the midface and improved overall facial symmetry, alignment, and function. We work closely with the patient's orthodontist (or we can provide a trusted specialist) to create a treatment plan tailored for the patient.

Malar refers to the cheekbone. Malar augmentation is used to enhance the appearance of facial symmetry using cheekbone implants or osteotomy, which surgically shortens, lengthens, or changes the alignment of a bone, for improved function.

Through malar augmentation, the surgical faculty at the Yale Maxillofacial and Orthognathic Program treat congenital or acquired defects. Examples of congenital defects that can be treated with malar augmentation include Treacher Collins syndrome and hemifacial microsomia. Acquired deficiencies may be due to trauma, radiation, or aging.

By using advanced 3D imaging to assess the patient's specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

Malar deficiencies vary from person to person, so our comprehensive surgical team creates a treatment plan that is specific to the patient.

Mandibular angle reduction/augmentation is a procedure used to achieve aesthetically pleasing corrections of abnormal facial proportions due to congenital defects, trauma, or aging.

This form of jaw surgery may include making the jaw smaller to create a softer, oval appearance of the lower face. Or, it may involve redefining the mandible by adding jaw implants.

By using advanced 3D imaging to assess the patient’s specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

We create an extensive pre-surgical plan so that the patients can fully understand the degree of their jaw abnormality and the treatment process. Our goal is to maximize normal jaw function, such as speaking, eating, and chewing, as well as to enhance appearance by achieving better facial symmetry.

Palatal expansion is the widening of the upper jaw with an appliance called a palatal expander. The palatal expander is customized to fit the patient's palate and attached to the molar teeth. The appliance is activated through turning to gradually create a wider palate.

The appliance will correct crossbites of the molar teeth, make room for crowded teeth, and widen the upper jaw when it is smaller than the bottom jaw. The palatal expander is used in younger patients who are still growing but can be used effectively until the end of adolescence. This is because the jaw cannot yet be rigidly attached to the rest of the skull.

Because widening the upper jaw takes a multidisciplinary approach, our surgical team at the Yale Maxillofacial and Orthognathic Surgery Program works in conjunction with the patient's orthodontist (or we can provide a trusted specialist).

By using advanced 3D imaging to assess the patient’s specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

Segmental jaw surgery, also called orthognathic surgery, involves lower jaw surgery, upper jaw surgery, or both. Its function is to reposition the jaw to correct jaw alignment and malocclusions (the misalignment of the teeth or jaw).

If the patient has discrepancies or disproportions of the upper and lower jaws, and related structures, segmental jaw surgery can help them. Some of these discrepancies and disproportions include bite abnormalities, improper alignment of the lips, trouble with eating and speaking, facial imbalance, snoring or breathing problems, and pain in the jaw joints.

Our interdisciplinary faculty at the Yale Maxillofacial and Orthognathic Surgery Program work with the patient's orthodontist or, if needed, one we provide, to create a comprehensive treatment plan to:

  • Maximize the ability to speak, eat, and chew
  • Enhance the facial symmetry and appearance
  • Balance the jaw/face position
  • Minimize sleep apnea and snoring
  • Relieve jaw joint pain

By using advanced 3D imaging to assess the patient's specific condition, we can simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery. The 3D technology allows us to create a surgical plan with a level of accuracy not available with traditional imaging technology.

Meet Our Maxillofacial and Orthognathic Faculty
Derek Steinbacher, MD, DMD

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Please visit our section's site at YaleMedicine.org to learn more about what we offer adult and pediatric patients needing surgical treatment and our comprehensive care for a full range of conditions and diseases, from the most common to the most complicated.