At the Barcelona Maxillofacial Institute, there’s a Dr. Frederico Alfaro. About half of his patients, he said, are from abroad, with Americans making up the bulk.
“The second patient I saw this morning was from New York.” He told DailyMail.com. The clinic posts many photos of its patients’ changes online, attracting many foreign patients who want to change their jaw line, almost half of whom have undergone the procedure to improve their beauty.
The procedure involves cutting the mandible, repositioning it, and fixing it with titanium plates and screws. Sometimes, the bones of the middle face and jaw are cut to adjust the position.
If a patient wants to have the surgery, they have to give it to the clinic first. The clinic accepts and arranges an international package, including booking a flight, with the patient staying in Spain for at least a week. Surgery is usually done in an hour and a half, and the rest of the time is used for recovery.
Dr. Alfaro said the main problems with patients who come to him are that their faces are not three-dimensional enough, their jawline and neck lines are not distinct enough, and they do not look masculine enough. His clinic sees about 200 patients a year, at least half of them foreign.
Still, Dr. Alfaro says his team uses a “holistic approach” regardless, making sure clients are happy with the results, even if they don’t have to.
In the United States, surgery to reposition the jaw costs $17,000 to $19,000, and surgery to reposition the upper jaw costs about $7,000. Patients have to call for a preliminary consultation and send photos and medical records of their condition before surgery.
Many of the patients at the clinic have health problems, like misaligned teeth and sleep apnea, which can be caused by bone squeezing the airways.
The clinic also performs other cosmetic procedures like facelifts, cheek fillers, and blepharoplasty, which removes excess skin from the top of the eyes.
On the clinic’s social media, Gustavo, an 18-year-old Spaniard, is very popular. In 2024, he was referred to this clinic for Type 2 malocclusion. His upper teeth covered his lower teeth so badly that his eating was affected. Plus, he’s worried about how he looks and has mild sleep apnea.
Dr Alfaro said: ‘Gustavo has all these problems, but what matters most to him is his face. I think about half my patients are most concerned about that.”
To operate on Gustavo, doctors performed a bilateral sagittal split osteotomy, cutting the mandible and moving it forward to align the teeth, then fixing it with titanium plates and screws. Then we had a Le Fort I osteotomy, where we cut the upper jaw horizontally and moved it down to widen the airway and solve the sleep problem, which was also fixed with titanium plates and screws. Finally, he did the chin forward to make the chin look better.
They may also inject fat into the cheeks and lips to make the patient look better and feel more satisfied, Dr. Alfaro said.
There’s swelling and bruising after the surgery, and it takes about four weeks to go away. Many patients return to normal activity once the swelling subsides, but it can take up to six months for the bone to fully recover.
Gustavo told DailyMail.com that he was so surprised by the results of the surgery that he couldn’t believe it was him in the mirror. “Now I look at the pictures from before the operation and I still can’t believe it was me. I used to be afraid to talk to girls, but now I’m much more confident.”
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