Surgery is performed while you are deep asleep and pain-free (under general anesthesia), and may take from four to 14 hours to complete. During this time, some of the facial bones are cut and repositioned into a more normal facial structure. Pieces of bone (bone grafts) are taken from the pelvis, ribs, or skull to fill in the spaces where bones from the face and head have been moved. Small metal screws and plates are used to hold the bones in place. The jaw is also wired together to hold the new bone positions in place. If your surgery is expected to cause much swelling of the face, mouth, or neck, the airway becomes a major concern. The airway tube (endotracheal tube) normally used for long surgical procedures under general anesthesia will then be replaced with an opening and tube placed directly into the airway (trachea) of the neck (tracheotomy).