Before braces, I had to undergo two upper jaw surgeries (1st was a SARPE, 2nd was a Lefort I Osteotomy). Needed to widen my upper bite, then detach and pull the entire upper jaw (maxilla) forward 5mm. Only then could the braces align my teeth.

The surgeries were under my medical insurance, the braces were dental.

Search YouTube for SARPE...it's not for the squeamish.