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Oral Surgery/IVRO surgery


I have suffered from TMJ complications for the past 10 years, specifically lots of popping, clicking, a little locking, ringing in my ears, muscle pain, weakness, tingling in my neck after eating, etc.. and my oral surgeon has recommended IVRO surgery since the Arthrocentesis procedure has actually made my symptoms worse than they were before.  I have a list of questions I would like to ask you.  I am a 30 yo male, relatively healthy, I do have slight seasonal asthma due to allergies, prostatitis, and I am also a recovering addict with 3 years of sobriety.  I am extremely concerned with pain management after my surgery since I am on a daily dose of 4 mg of buepronorphine (subutex) and I know that it makes my physiological tolerance for opioid medications much, much higher.  Here is a list of questions that I have that I will also be asking my surgeon.  I have read mixed reviews on this surgery so i would like to get as much input as possible.

2.Will I need a blood transfusion
3.Will I need my chin shaved
4.Will it affect my bite
5.How will it affect the way my face looks?
6.What are the possible complications?
7.How will my airway be kept open
8.Will I have to stay overnight in the hosital?
9.How many of these surgeries have you done?
10.What is the success rate?
11.Will I need orthodontic care after my surgery?

Hello Jeremy,

IVRO as you know has mixed reviews, particularly regarding TMJ issues.  I do not know if you have jaw deformity as well or not. So therefore no to BSSO. Usually there is no need for blood transfusion. I am not sure why they would shave your chin if the issue is in the joints. Again, I have not seen your profile pictures. IVRO could possibly affect your bite. It has to be monitored carefully by the surgeon post operatively. If it is only for TMJ issues, it would not have any effects on the face. Possible complications are mal-union, infection, hematoma, malocclusion. Your jaw would have to be wired shut. You could still breath but your asthma is a concern and should be worked up by your M.D.
Usually you do not have to stay in the hospital. I have done more than 300 of these procedures. again the success rate for the TMJ issues are 50/50.  It depends on the diagnosis and why you have those issues. You might consider Arthroplasty. Post operatively, you would need care from your surgeon every week for atleast 6 weeks.

Thank you and good luck!

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Majid Jamali, D.M.D. Fellowship trained in corrective jaw surgery


Diplomate, American Board of Oral & Maxillofacial Surgery Full scope Oral & Maxillofacial Surgery, Orthognathic Surgery, Genioplasty and Anesthesiology I have completed an additional two years of fellowships in orthognathic surgery and anesthesiology field.


Faculty at numerous hospitals


New York Dental Society Journal

Tufts University: Dental School SUNY Down-State Medical Center: OMFS residency Robertwood Johnson Medical Center: Anesthesiology fellowship Lenox Hill hospital: Orthognathic fellowship

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