What is the cost of corrective jaw surgery?

Corrective jaw surgery is a commonly sought after procedure today. When such it was first done in Singapore, as it was in other countries, it was deemed to be a major surgery that requires long hours of operation with postoperative intensive care. Today, most double jaw surgeries can be done in about four hours with about two days of recovery in a general ward. This is a result of the refinement the surgical and anesthetic techniques over the years that reduces the complications and improves efficiency of the operation itself. However, the cost of  surgery has remained fairly high. This is because much of the improved "productivity" comes from using advance technologies which increases cost. As the surgery becomes safer, the cosmetic demands of the patient also becomes more sophisticated. Today, patients seeking corrective jaw surgery does not merely seek an improvement in function. In fact, more often than not, the patient is actually seeking cosmetic jaw surgery. As such, more time is needed in the pre-surgical assessment to determine the aesthetic expectations of the patient, and this usually requires the use of computer simulated surgeries on virtually reconstructed models generated from CT scan data. Let's take a look at what makes up the cost of corrective jaw surgery.

There are different approaches for patients with different expectations, needs and demands. Some patients takes the "Just do it" philosophy. This group of patients are not interested in the cosmetic effects of the surgery. They only want the surgery to correct the position of the jaws so that their orthodontist are able to align their teeth properly. They do not need nor want to go into a discussion of what the cosmetic outcome is likely to be with different options. As such, treatment plan for them usually consist of a single jaw operation, with one night stay in the hospital and they can pretty much go home the next morning. However, most patients seeking corrective jaw surgery do so for cosmetic reasons. For this group, the preoperative discussion is usually more protracted and double jaw surgery is usually needed to achieve their aesthetic goals. Let's look at what the cost is like at different stages.

Initial assessment: This typically takes two to three visits. At the first visit, I will do a preliminary assessment of the patient and discuss general options that are suitable for the patient. This will usually take about hour an hour to one hour. Consultation fee up to this point will range from $100 to $200.

Diagnostic records: With this initial information, the patient then decides whether he wants to take the next step, which is to take diagnostic records comprising CT scans, dental casts, photos, etc. Some patients need time to consider while others choose to proceed with record taking at the same visit. A complete set of diagnostic records will take about 30 minutes and cost about $1500-2000.

Review of treatment options: About two weeks after the diagnostic records are taken, the patient comes back to review the treatment options. Here, we go through the computer simulation of the effects of the surgery on the face. This is when the patient indicates that he prefers, for example, a more prominent chin, and we simulate that on the computer and see the effect. The cost of this session is about $100-$200.

Orthodontics: some patients require braces prior to surgery. A referral will be made to an orthodontist if the patient does not already have one. Pre-surgical orthodontics may range from $6000-$8000, depending on the complexity and duration needed. 

Surgery: An updated set of records will be taken one month before the surgery to be sent to the laboratory to fabricate a set of surgical guides that will position the jaw in the planned position. Some patients will also do to the blood bank to "donate" some of his own blood for use after surgery. On average, a single jaw operation will cost about $25000 while a double jaw surgery will cost about $35000. This will cover the cost of a 3-4 hours of operating theater use, one to two days of hospital stay, surgeons' and anesthetist's fees. Medisave can be used to pay for part of this bill. The Medisave withdrawal limit for a double jaw surgery is about $7500. I will review the patient weekly for a month after which he goes back to the orthodontist to finish off the braces.

Corrective jaw surgery is certainly not cheap. There may be considerable variation in charges in different clinics and hospitals. It is not always easy to compare prices of services as different surgeons have different protocols. Do check up on a few practices including some public hospitals. Ultimately, the choice of surgeon is a personal decision based primarily on whether you trust that surgeon to do the best work for you.