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Jaw Surgery at the Hampshire Clinic

When braces alone cannot make the bite right.

We offer jaw surgery with orthodontic treatment to people whose jaws are too long, too short or not symmetrical.

We are two surgeons whose skills encompass current oral and maxillofacial surgery practice. Our private practice is based at the Hampshire Clinic.

About Jaw Surgery | About the Surgeons | About the Hampshire Clinic | Getting There - Travel Advice | Patient Feedback | Contact Us | Legal Statements

About Jaw Surgery and Orthodontic Treatment

Who may benefit?

In order to correct the position of the teeth and provide a functioning bite, the supporting bones of the jaws need to be in the correct position. We offer jaw surgery with orthodontic treatment to people whose jaws are too long or too short or not symmetrical, as braces alone cannot make the bite right if the jaws are not. Sometimes this surgery is indicated when a broken jaw has healed in an incorrect position.

The jaw surgery is usually done anytime after the person has stopped growing; the orthodontic treatment can be started a year or two earlier. This is a standard form of treatment which is available in many NHS hospitals. The main benefits are:

Do I have to have it done?

No. The whole process is entirely optional and should be what you want to have done. We are very happy to undertake treatment for anyone who may benefit and who feels that it is right for them to go ahead once they understand what is involved.

Why do I need a brace as well?

The teeth need to be moved so that the top and bottom teeth will meet properly when the jaws are put into the correct position. The brace used is a fixed brace (train tracks) as this can position the teeth most accurately. If jaw surgery is undertaken without orthodontic treatment, the result may be compromised, and can be unstable.

How long does it all take?

The whole process usually takes two to three years and involves:

  1. Detailed assessment of the problem with models of the teeth, X-Rays, photographs, and occasionally special scans.
  2. Meeting with Consultants in Maxillofacial Surgery and Orthodontics to discuss what is involved, the risks and benefits, and the other options.
  3. Decision by the patient (and his or her family).
  4. Orthodontic treatment with fixed braces (and extractions of some teeth if necessary).
  5. Removal of wisdom teeth (if necessary). This may be required, ideally six months before jaw surgery to the lower jaw, as the lower wisdom teeth sit in the line where the jaw division is to take place. Healing is much better after jaw surgery if the wisdom teeth have been previously removed and the sockets have had time to fill with new bone. Some people do not grow wisdom teeth or do not need to have them removed.
  6. Jaw surgery, usually in one operation.
  7. Further orthodontic treatment.
  8. Retention with removable braces and follow up.

Orthodontic treatment with fixed braces for up to eighteen months is needed to straighten the teeth and put them in the right positions for jaw surgery. This may make the problem look worse but is necessary so the jaws can be fully corrected. The fixed braces stay in place during and after the operation.

After the operation the orthodontic treatment is usually continued for another few months. The fixed appliances are then removed and removable retainers are fitted. These are worn initially full time and indefinitely at night.

How will the operation be done?

The operation is done under a general anaesthetic in hospital. It involves dividing one (or both) jaws and resetting it (or them) in new pre-planned positions with screws and/or small metal plates on the surface of the bones. This is all usually done from inside the mouth with only two small puncture wounds in the skin at the side of the face for placing some screws. The screws and metal plates normally do not need removal (they do not activate airport alarms!) and the stitches dissolve.

What happens afterwards?

After waking up in recovery, the patient goes back to the surgical ward. The jaws are not usually wired together but may be guided into their new position by elastic bands stretched between the upper and lower orthodontic braces. There is sometimes considerable swelling with bruising of the face and mouth at this stage, with discomfort rather than pain, and limited mouth opening. Medication is given to make the patient as comfortable as possible and to reduce the risk of infection.

Liquids, medication and rarely blood are given by a 'drip'. The patient then moves onto a liquid diet and usually stays in hospital for only a couple of days. The swelling often persists for two weeks and the patient is usually fit to go back to work or college about the same time. Weekly visits to out-patients are needed for a month and contact sports must not be played for at least six weeks. Orthodontic visits then continue as required and the braces are removed when the time is right.

We continue to review you after surgery.

How will I eat?

You will be on liquid food initially and it is a good idea to make sure you will be able to use a liquidiser or food processor after the operation. You will need to eat several meals a day to keep your intake up. Normal food liquidised with milk is good, as are high protein soups. After a couple of weeks you will be able to manage scrambled egg, mashed potato or soft pasta type foods, and it will take up to six weeks before anything should be chewed. Further information can be found on our Post-Surgery Modified Diet page.

What are the risks?

All operations carry general risks. These can be reduced by making sure you are in the best condition for an operation, such as:

The particular risks with jaw surgery are:

We make every effort to minimise these risks and most patients are pleased with the result and think the treatment has been worthwhile.

How do I decide if it is for me?

Talk to us as many times as you feel you need to and ask your friends and family for advice if you wish. We hope this information will help you to understand the treatment we are offering you. We will be happy to discuss your particular problems in more detail. It is important that you understand what is involved before you decide to go ahead.

Please contact us if you have questions or would like to ask us about arranging for surgery.

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About the Surgeons

Carrie Newlands and Cyrus Kerawala work together in several hospitals. They have similar yet complementary clinical skills encompassing the breadth of current oral and maxillofacial surgery practice.

They are active in Clinical research and Audit, examine for post-graduate qualifications such as MFDS, MRCS and FRCS, and are both assistant editors of the International Journal of Oral and Maxillofacial Surgery.

They regularly operate together and are always happy to see patients referred by colleagues in Primary Care. (Patients visiting this website are advised to obtain a referral from their doctor or dentist if they would like to be seen).

Mr Cyrus Kerawala BDS, FDSRCS, MBBS, FRCS(MaxFac)

Consultant: Consultant Maxillofacial Surgeon; Year qualified: 1985 Dental School, 1992 Medical School

Primary speciality: Oral and Maxillofacial Surgery; Secondary speciality: Cosmetic surgery

Professional memberships: British Medical Association; British Association of Oral and Maxillofacial Surgeons; British Association of Head and Neck Oncologists

Clinical interests: Cosmetic Facial Surgery; Head and Neck Surgery; Salivary Gland Surgery

NHS hospitals: North Hampshire Hospital; Royal Surrey County Hospital. Private hospitals: The Hampshire Clinic, BUPA Hospital Clare Park, Farnham, Guildford Nuffield Hospital

Private practice: The Hampshire Clinic, Basing Road, Old Basing, Basingstoke, Hampshire RG24 7AL, tel: 01252 850106, fax: 01256 313243

Miss Carrie Newlands BDS, FDSRCS, MB BCh, BAO FRCS (OMFS)

Consultant: Consultant Maxillofacial Surgeon; Year qualified: 1985 Dental School, 1994 Medical School

Primary speciality: Oral and Maxillofacial Surgery; Secondary speciality: Oral medicine

Professional memberships: British Medical Association, British Dental Association, British Association of Oral and Maxillofacial Surgeons

Clinical interests: Orthognathic Surgery, Skin Cancer, Paediatric Oral Surgery

NHS hospitals: Royal Surrey County Hospital, Guildford; North Hampshire Hospital. Private hospitals: Guildford Nuffield, Mount Alvernia, Guildford; The Hampshire Clinic

Private practice: Guildford Nuffield Hospital, Stirling Road, Guildford GN2 7RF, tel/fax: 01483 302673

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About the Hampshire Clinic

The Hampshire Clinic is part of BMI Healthcare, Britain's leading provider of independent healthcare with nearly fifty hospitals across the United Kingdom. It provides facilities for advanced surgical procedures together with friendly, professional care.

The Hampshire Clinic has 65 beds, all with en suite facilities, satellite television and telephone. The hospital has four operating theatres and an outpatient theatre.

The Clinic combines the latest in technology with high-quality on-site support services, enabling its consultants to undertake a wide range of procedures. These specialists, together with the clinic's Resident Medical Officers, who are on duty 24 hours a day, provide expert care.

Contact details for the Hampshire Clinic can be found on the BMI website.

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Getting There: Travel Advice for Patients from Ireland

Your operation has been arranged in conjunction with the National Treatment Purchase Fund. The NTPF is a Government funded initiative established to reduce waiting lists in the Republic of Ireland.

Once you have been seen by your Consultant, arrangements will be made for you to travel to the UK to have your operation at The Hampshire Clinic.

The Hampshire Clinic is a private hospital situated in Old Basing, Hampshire. The Hampshire Clinic is owned by General Healthcare Group. It is approximately 30 miles south of London and about ¾-hour drive from Heathrow airport, the airport you will fly into.

Our policy is always to provide you with the best care. We continually invest in staff, facilities and equipment, which enables us to attract the area’s leading consultants.

The Hampshire Clinic is a 61-bedded hospital and you will be cared for in one of our single, ensuite bedrooms. We also have a critical care unit, four operating theatres and a comprehensive outpatients department.

Once your operation date has been confirmed, you will be contacted by Club Travel from Dublin who will arrange your road and air bookings. They will also arrange hotel accommodation for your companion. They will provide you with a travel itinerary, tickets and an emergency back-up service.

You will be met at Terminal 1, Heathrow airport by a taxi booked by the Hampshire Clinic who will be waiting for you at arrivals and have a board with your name on it. The same taxi company will take you back to Heathrow on the day of your discharge.

Your companion is welcome to spend as much time as they wish here with you at The Hampshire Clinic but we would expect them to have left by 10.00pm to ensure your night’s sleep.

When you have been discharged and return home to Ireland, Matron will ring you to ensure all is well, but if you have any worries or concerns, please do not hesitate to contact the ward on 0044 1256 357111. A follow up appointment will be sent to you to be seen in outpatients in Cork.

Costs that are covered for you and your companion

Useful telephone numbers

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Patient Feedback: satisfaction surveys

Results of survey

All our patients have felt well informed, well looked after and are glad or very glad that they had their jaw surgery at the Hampshire clinic.

Asked: 'If you had a friend who needed similar surgery would you recommend the Hampshire clinic?', 100% said yes strongly or very strongly.

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Contact Us

To find out more about jaw surgery procedures and to enquire about our service at the Hampshire Clinic, please contact us.

Carrie Newlands

tel/fax: 01483 302673
email: cn@jawsurgery.co.uk

Cyrus Kerawala

tel: 01252 850106; fax: 01256 313243
email ck@jawsurgery.co.uk

If you come across a problem with the functioning of this website, please contact the webmaster: webmaster@jawsurgery.co.uk

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