Bilateral Sagittal Split Osteotomy (BSSO)

About Bilateral Sagittal Split Osteotomy (BSSO)

BSSO surgery in Lucknow is one of the most refined techniques in modern orthognathic care. The mandible is split along a controlled plane that runs through the angle and body of the jaw, creating two overlapping bone segments. The tooth-bearing portion is then repositioned forwards, backwards, up or down to correct the underlying skeletal problem. Because all incisions are inside the mouth, there are no visible facial scars, and recovery focuses on internal healing rather than external wound care.

Mandibular osteotomy is highly versatile. We use it to correct mandibular retrognathia (a recessed lower jaw), prognathism (a protruded lower jaw), facial asymmetry where the chin sits off-centre, anterior open bite and certain obstructive sleep apnoea cases linked to a small mandible. It also forms half of bi-jaw surgery when both jaws need to move together. Dr. Agarwal, FRCS Edinburgh, decides the precise direction and amount of movement using cephalometric analysis and 3D virtual planning.

Surgery is performed under general anaesthesia with nasal intubation. After an intraoral incision behind the lower molars, fine cuts are made on the inner and outer cortices of the mandible. Specialised instruments split the bone gently along these planes. The repositioned segment is fixed with titanium plates and screws, and intermaxillary elastics or wires may be applied briefly to guide the bite. The whole operation is closed with absorbable sutures inside the mouth, sparing the face from any scar.

Jaw alignment correction with BSSO is rarely a stand-alone event. Most patients undergo seven to twelve months of pre-surgical orthodontics to align the teeth within each jaw before surgery. After surgery, a further six to nine months of orthodontic refinement settles the final bite. We coordinate closely with your orthodontist throughout, sharing imaging and timelines so the entire orthognathic lower jaw surgery journey feels like one continuous plan rather than disconnected appointments at separate clinics.

What to expect

• Detailed work-up with photographs, dental scans and 3D imaging
• Pre-surgical orthodontics, typically seven to twelve months
• General anaesthesia with experienced anaesthetic support
• Intraoral incision behind the lower molars, no visible facial scar
• Controlled mandibular split and precise repositioning
• Fixation with titanium plates and screws plus absorbable sutures
• Hospital stay of one to two nights with structured pain control

Recovery

• Soft and liquid diet for roughly six weeks while bone consolidates
• Most facial swelling settles within two to three weeks
• Numbness of the lower lip and chin is common and usually recovers over months
• Office return is typical in three weeks for sedentary work
• Strict oral hygiene with prescribed rinses and gentle brushing
• Final bite settled with post-surgical orthodontics over six to nine months