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occasional small external incisions may be used for hardware in some cases.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single surgical procedure (one operation); orthodontic treatment before and after is separate."},"stages":[{"code":"orthognathic_operation","label":"Orthognathic jaw surgery under general anesthesia","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery after completed pre-surgical orthodontics."}}],"qualifier":"Counts only the surgical operation; orthodontic phases and follow-up checks are not included."},"success":{"metric":"Stable functional occlusion with planned jaw correction, no unplanned corrective surgery","value":85,"unit":"percent","horizon":"12 months after surgery","population":"Adults with dentofacial deformity after planned bimaxillary surgery; excludes cleft, syndromic, trauma cases","evidence_status":"limited"},"techniques":[{"name":"Bimaxillary surgery (Le Fort I plus bilateral sagittal split osteotomy)","suits_whom":"Adults with combined upper and lower jaw discrepancies, or maxillomandibular advancement for sleep apnea.","recovery":"Hospital 1-3 nights; swelling peaks in week 1 and improves over 2-4 weeks; light work often at 2-4 weeks, up to 4-6 weeks."},{"name":"Bilateral sagittal split osteotomy alone","suits_whom":"Isolated mandibular advancement or setback.","recovery":"Swelling 2-4 weeks; possible lower lip numbness; often a shorter course than bimaxillary."},{"name":"Le Fort I osteotomy alone","suits_whom":"Isolated maxillary advancement, impaction, or vertical/transverse change.","recovery":"Nasal congestion and swelling for 1-2 weeks."},{"name":"Genioplasty added to jaw surgery","suits_whom":"Chin position correction, usually combined with jaw surgery.","recovery":"Mild additional swelling and chin numbness."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":4,"max":6,"unit":"hours","qualifier":"Operating time for bimaxillary Le Fort I plus BSSO; single-jaw surgery is shorter."},"initial_assessment_documents":["Front and side facial photos, smiling and relaxed","Intraoral bite photos","Panoramic dental X-ray (OPG)","Lateral cephalometric X-ray","Jaw CBCT scan (if available)","Orthodontist treatment plan and current braces status"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"One trip with 14-21 days stay; orthodontics and reviews done at home. Second trip only for in-person review."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check whether the surgeon has hospital privileges to perform this procedure. Why: privileges show approval to perform it at that facility","scope":"procedure","source":{"url":"https://www.plasticsurgery.org/reconstructive-procedures/orthognathic-surgery/consultation","host":"plasticsurgery.org","quote":"Do you have hospital privileges to perform this procedure?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Check the qualifications of the whole medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check that you have been able to ask the team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Check the language ability of all care staff, not only the doctor","scope":"treatment_abroad","source":{"url":"https://www.orthoinfo.org/en/treatment/what-to-know-about-medical-tourism","host":"orthoinfo.org","quote":"Even if your physician speaks English, other patient care providers may not.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Warning sign: a hospital that markets surgery as a holiday package","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Beware of any hospital which markets cosmetic surgery as a holiday package.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Warning sign: treatment advice comes from sales staff or agents rather than clinicians","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Do not accept advice from a travel agent, sales representatives or administrators.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"Warning sign: no face-to-face consultation with the operating clinician before surgery","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"A face-to-face consultation with the health professional who will carry out any planned surgery or treatment must take place before any procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Pus or discharge from the 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Celsius)","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives your home doctor hospital treatment details and any ongoing medication","document":"discharge summary letter","source":{"url":"https://royalwolverhampton.nhs.uk/patients-and-visitors/staying-in-hospital/going-home/","host":"royalwolverhampton.nhs.uk","quote":"A discharge summary – this is a letter that includes details of your hospital treatment and any ongoing medication.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried 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