Maxillofacial refers to the entire region of your face that includes the jaws, cheekbones, eye sockets, nose, and the surrounding soft tissue. In medicine and dentistry, the term most often comes up in the context of oral and maxillofacial surgery, a specialty focused on treating injuries, diseases, and structural problems of the head, neck, face, and jaws. If you’ve been referred to a maxillofacial surgeon or heard the term on a medical form, it simply describes the area of the body being treated: everything from the upper neck to the forehead, centered on the jaw and midface.
The Anatomy Behind the Name
The word “maxillofacial” combines “maxilla” (your upper jaw) with “facial.” The maxilla is a pair of bones that fuse at the midline of your face. It does far more than hold your upper teeth. It forms part of the floor of your eye sockets, shapes the sides of your nasal cavity, and supports the overall structure of your midface. When surgeons say “maxillofacial region,” they mean the maxilla plus all the surrounding bones and tissues: the lower jaw (mandible), cheekbones (zygomatic bones), the bones around the eyes, and the nose.
This interconnectedness is why maxillofacial problems rarely affect just one structure. A fracture to the midface, for example, can involve the eye socket, the nasal cavity, and the roof of the mouth simultaneously. Surgeons classify severe midface fractures into three patterns, called Le Fort fractures. A Le Fort I is a horizontal break that separates the upper jaw from the rest of the face. A Le Fort II follows a pyramid-shaped path through the nasal bones and orbital floor. A Le Fort III is the most severe: a complete separation of the entire facial skeleton from the skull base. These classifications illustrate why the region demands its own surgical specialty.
What Maxillofacial Surgeons Do
Oral and maxillofacial surgery is one of the broadest surgical specialties. These surgeons handle conditions ranging from impacted wisdom teeth to head and neck cancers. The core areas of practice include:
- Corrective jaw surgery (orthognathic surgery) to realign jaws that don’t meet properly
- Facial trauma repair including fractures of the jaw, cheekbones, and eye sockets
- Tumor and cyst removal in the jaws and surrounding bone
- Dental implant placement and bone grafting for patients who lack sufficient jawbone
- TMJ disorder treatment for chronic jaw joint pain and dysfunction
- Reconstruction after cancer surgery, trauma, or congenital abnormalities like cleft lip and palate
The specialty sits at the intersection of dentistry and medicine, which is reflected in the training. A maxillofacial surgery residency typically lasts six years. At programs like Mayo Clinic’s, residents complete two years of general surgery training and two years of medical school (earning an MD) alongside their surgical training. They pass the same licensing exams as other physicians. This dual background is what allows them to manage everything from a straightforward tooth extraction to a twelve-hour reconstructive operation on a shattered face.
Corrective Jaw Surgery
One of the most common reasons people encounter a maxillofacial surgeon is corrective jaw surgery. Braces can reposition teeth, but they can’t change the shape or position of the jawbone itself. When the upper and lower jaws are significantly misaligned, causing an overbite, underbite, or asymmetry that affects chewing, breathing, or appearance, surgery is the only option that addresses the skeletal structure.
During the procedure, the surgeon makes cuts inside the mouth to access the jawbone, repositions it, and secures it with small plates and screws. A splint is placed over the teeth for stability. The same approach is used for conditions like obstructive sleep apnea (when a recessed jaw narrows the airway), jaw cysts and tumors, and facial asymmetry present from birth.
Facial Trauma and Reconstruction
Maxillofacial surgeons are often the specialists called in for facial injuries, whether from car accidents, falls, sports, or violence. The goal is to restore both function and appearance. For fractures, the standard approach is to realign the broken bones and fix them in place with small titanium plates and screws. For injuries involving significant bone loss, surgeons may transplant bone from another part of the body, often the lower leg (fibula) or hip, along with its blood supply to keep the tissue alive. These are called free flaps, and they allow reconstruction of large sections of jawbone or facial structure.
Reconstruction after cancer surgery follows similar principles. When a tumor in the jaw or mouth requires removal of bone and surrounding tissue, maxillofacial surgeons use 3D computer planning to map out exactly how donor bone should be shaped to rebuild the patient’s face. The aim is to restore the ability to eat and speak while preserving normal facial contours as much as possible.
TMJ Disorders
The temporomandibular joint (TMJ) is where your lower jaw connects to your skull, just in front of each ear. Problems with this joint cause pain, clicking, locking, and difficulty opening the mouth. Maxillofacial surgeons manage TMJ disorders with a tiered approach, starting with the least invasive options.
Initial treatments include custom splints (similar to night guards but designed to reposition the jaw), physical therapy exercises, over-the-counter pain relievers, and sometimes muscle relaxants or Botox injections into the jaw muscles to reduce clenching. Ultrasound therapy and electrical nerve stimulation can also help relax the surrounding muscles.
If those approaches don’t work, there are several surgical options. Arthrocentesis is the simplest: small needles are inserted into the joint to flush out built-up fluid. Arthroscopy uses a tiny camera inserted through a small incision near the ear, allowing the surgeon to reshape bone, reposition the joint disc, or remove scar tissue. Open-joint surgery is reserved for the most severe cases and may involve repairing or replacing the joint entirely.
Bone Grafting and Dental Implants
General dentists place many dental implants, but complex cases often require a maxillofacial surgeon. When you’ve been missing teeth for a long time, the jawbone beneath those gaps gradually shrinks. If there isn’t enough bone to anchor an implant, a bone graft is needed first. The surgeon adds bone material to the deficient area, sometimes using titanium mesh or other frameworks to shape and protect the graft while it heals. Once the site has rebuilt enough volume and density, implants can be placed.
This type of grafting is also common after tooth extractions, facial trauma, and reconstructive surgery. The goal is always the same: providing enough solid bone for whatever comes next, whether that’s an implant, a prosthetic, or simply restoring the natural shape of the jaw.
How Maxillofacial Differs From Plastic Surgery
There’s significant overlap between these two specialties when it comes to facial procedures, but the training paths and core focus differ. Maxillofacial surgeons train through dentistry and then complete a surgical residency that emphasizes the jaws, teeth, and the functional aspects of the face: chewing, breathing, speaking, and bite alignment. Plastic surgeons train through general surgery and then specialize in reconstructive and cosmetic procedures across the entire body, including the face.
In practice, both specialties perform facial fracture repair and reconstruction. But if your problem involves the teeth, jaws, or bite, a maxillofacial surgeon is typically the right specialist. Most patients are referred by their dentist after an exam reveals a problem that falls outside what standard dental treatment can fix, such as a jaw that’s too far forward, a cyst growing in the jawbone, or chronic facial pain that hasn’t responded to other treatments.