Protruding Mouth Correction (ASO)

Mouth protrusion can come from teeth that angle forward, jawbones that sit too far forward, thick lips, or a chin that is set back, making everything look more prominent. Your surgeon uses bite records, skull X-rays, photos, and lip competence tests to figure out which parts are responsible. We walk you through each layer so you understand whether braces, bone surgery, or both are the right tools.

Orthodontics alone moves teeth within the bone and works when the protrusion is purely dental. An anterior segmental osteotomy moves a tooth-bearing bone segment backward, often into premolar extraction space. Two-jaw surgery is reserved for a broader jaw-base discrepancy where both jaws need repositioning. The right choice depends on whether the bone itself is too far forward or just the teeth, and your surgeon uses imaging to make that call.

If premolars are extracted, the front segment of bone that carries your front teeth is cut free and slid backward into the extraction space to reduce the protrusion. This moves bone, gums, and teeth together as one unit while preserving the blood supply through the soft tissue attachment on the inside. Your surgeon explains whether you need extractions and how the segment will be repositioned based on your specific bite and bone pattern.

The planned setback in millimetres is measured on your cephalometric tracing, and reducing protrusion will decrease lip support, which can make the lips look thinner and the nose or chin look relatively stronger from the side. Too much setback risks a flattened appearance around the mouth. Your surgeon plans a balanced movement that improves your profile without aging it, and shows you the planned change against your facial proportions.

Yes, setting back the tooth-bearing bone reduces the support behind the upper lip, which can thin the lip and make the nose appear larger by comparison. An overly flat mid-face is a known risk of excessive setback. We plan the movement conservatively, check the facial balance on your tracings, and tell you how your lips and nose might look differently beforehand so there are no surprises.

The blood supply to the front teeth and bone comes mainly through the soft tissue on the palate side, which stays attached while the bone segment is cut free and moved. The nerve bundle that supplies tooth sensation is also mapped on imaging and avoided during the cuts. Your surgeon explains which structures are preserved and how, and checks tooth vitality at follow-up visits.

Braces are typically needed before surgery to align the teeth and create room, and after surgery to fine-tune the bite and close any remaining gaps between teeth. The total orthodontic timeline is part of the treatment plan. We coordinate with your orthodontist so the surgical and orthodontic phases are in sync.

Swelling, lip numbness, and speech changes improve over the first few weeks, while lip drape, bite finishing, and residual numbness can take several months. Chewing is restricted to soft foods until the bone segments have healed. Your surgeon gives you a phased timeline and tracks whether the numbness is shrinking and speech is returning at each follow-up.

Lip closure often feels strange in the first weeks because of swelling and the new tooth position, but it usually improves as swelling goes down and your lips adapt. Judging lip competence is more reliable after a couple of months when the soft tissue has settled and the swelling inside the mouth has resolved. We compare your closure to your preoperative video and let you know whether the improvement is matching the plan.

Tooth vitality can be affected if the blood supply is compromised during the bone cuts, and some teeth may need root canal treatment if the nerve does not recover. Gum recession, bone not healing, and bite relapse are known risks that are monitored postoperatively. Your surgeon checks tooth vitality and gum health at follow-up visits and addresses any issues as they arise.

Yes, reducing mouth protrusion changes how the chin and nose look in relation to the new lip position, so combining it with chin surgery or rhinoplasty can create a harmonious profile in one plan. The combination adds operating time and swelling, so we discuss whether staging or doing them together makes more sense for you. A consultation is the best way to see how each procedure interacts with the others in your specific face.

Minor bite issues can be finished with orthodontics. A segment set back too far or too little may need a repeat bone cut, but scar tissue and tooth-root constraints make the second surgery more limited. A consultation reviews what is still changeable versus what is best left as is, and we weigh the risk of another operation against the benefit of a small additional correction.