Young adults’ experience of appearance-altering orthognathic surgery: a longitudinal interpretative phenomenologic analysis

Objective: To gain an experiential account of the processes of change associated specifically with orthognathic surgery. Design: A qualitative design was used. Semi-structured interviews were carried out with seven participants approximately one week before and six to eight weeks after surgery. The data was analysed using Interpretative Phenomenological Analysis (IPA). Setting: Participants were recruited from a NHS Dental Hospital. Participants: Patients aged 16-25 scheduled to undergo orthognathic surgery on both the upper and lower jaws, were purposively sought to participate. Seven participants aged between 18-25 years and who had undergone a bimaxillary osteotomy completed interviews (five females and two males). Results: Themes were identified in connection with the overall journey of treatment being a right of passage; the treatments role in raising awareness about anomalies in appearance; the initial shock at the changes that followed surgery; the uncertainty about treatment; the impact of actual negative reactions of others; and the role of significant others in the decision making process. Conclusions: Participants described undergoing a much more complex process of adjustment to change in appearance than has been identified elsewhere within the literature, and the study highlights the nuanced fashion in which both medical and parental communication influence patient expectation and experience of surgery. There is a need to improve communication between clinicians, families, and young adults seeking orthognathic surgery. Further studies are needed to investigate the processes associated with seeking to change facial appearance resulting from other forms of dentofacial condition.