Corrective Jaw Surgery - cost considerations

One of the major concerns that patients have about corrective jaw surgery is cost. While the most obvious effect of corrective jaw surgery is an improvement in aesthetics, it is not classified as a cosmetic procedure because there are also significant functional benefits associated with it. As such, the cost of jaw surgery in Singapore can be partially financed using Medisave. Hence the term corrective jaw surgery and cosmetic jaw surgery are often used interchangeably. Let's take a look at the breakdown of the cost of jaw surgery.

Preliminary cost

In my practice, the first visit is primarily an exploratory visit. The patient tells me what he/she is would like to change and how. This gives me an idea of what kind of look the patient likes. I will then do a physical assessment to determine where the problem is and make a provisional diagnosis. With that, we discuss possible treatment plans and the attendent costs, risks and complications. This visit typically takes about 30 minutes which will cost the patient $100. After this initial contact, if the patient wants to take it to the next step, we will take records to do a thorough analysis.

Diagnostic workup

The record taking consist of full face photographs and CT scans, dental impressions for dental casts, dental panoramic tomogram and facebow record. The photos are merged into the CT scans and imported into a simulation software. Surgery is then simulated on the software which will then show the changes in facial appearance that is associated with the bone surgery. The software also enable measurements of the degree and type of movement of different parts of the jaw that is needed to achieve the desired look. This diagnostic workup cost about $1800.

Surgery:

After the diagnostic workup, if the patient decides to go ahead with surgery, preparation is made. Cost of corrective jaw surgery comprises three different parts:

1. Professional fees: These are the charges of the attending surgeon (ie the surgeon in charge of your operation), the second surgeon or assistant (ie another fully qualified surgeon who assist the attending surgeon) and the anesthetist (ie the doctor that administers the anesthetic). The total professional fees may range from $18000 to $22000, depending on the complexity and time needed. In the private practice setting in Singapore, the surgeons and anesthetists are usually independent practitioners and are not employed by the private hospital

2. Hospital charges: The hospital charges include the use of facilities such as the operating theater, the ward, the nursing staff, the admininstrative staff, the drugs and materials. The range is from $10000-$15000, depending on the time spent in surgery, length of stay in the ward, the class of ward chosen, etc. 

3. External vendors: Titanium plates and screws are needed to fix the jaw in the new position. These fixation devices are provided by external vendors and bill either through the surgeon's clinic or the hospital For a double jaw surgery, the cost of the plates is about $3000.

Orthodontic treatment:

In the past, most cases require a period of pre-surgical orthodontics to prepare the teeth for surgery. However, recent improved understanding about orthodontic tooth movement and jaw surgery has led to many cases being done on a "surgery-first" approach. However, orthodontic treatment is still needed for proper alignment of the teeth for a long term stable result. Orthodontic treatment for orthognathic surgery is more complex than non-surgical orthodontics and the cost can also be more variable, ranging from $6000-12000. However, orthodontic treatment is paid gradually over the duration of treatment of about 2 years.

Medisave and Insurance:

Medisave can be used to cover part of the cost of surgery in Singapore, up to a limit of about $7500. Beyond that, the patient will need to come up with his/her own money. Some patients have very comprehensive insurance coverage and are able to get the insurance company to underwrite the surgery. In such cases, all that is needed is a letter of guarantee from the insurance company.

Cost is a major consideration in an elective procedure like corrective jaw surgery. However, it should not precede the consideration of whether or not surgery is going to solve your problem. As such, it is of paramount importance that proper process of discussion with the surgeon be done prior to discussing the costs. Only by knowing that the surgery is indeed what you want that you will find the means to finance it.  The last thing you want is to undergo a surgery that you can afford but it does not solve your problem.