Post-Operative Instructions: Orthognathic Surgery

If you are having any questions or concerns after your surgery, you can reach your doctor 24 hours a day by calling our office number. We should always be your first resource if you are having difficulty.

You will receive general anesthesia during your procedure as well as various pain medications immediately afterward, so when it is time for you to go home you will leave in the care of your escort. It is important that the person be willing and able to look after you and take responsibility for you until you are adequately recovered to be on your own. How long that will take varies greatly and depends entirely upon the individual. You will, however, need someone with you for up to a week following your surgery.

It is important for the week following your surgery that you keep your head elevated as much as possible. If you can sleep with your upper body elevated, this will reduce the amount of swelling you experience and you will have less pain. It is also helpful to apply ice intermittently on the sides of your jaw for several days following surgery. It is best to wrap the ice pack in a thin towel and to use it for only 15 minutes at a time, alternating sides. If you leave it in one place too long, you can injure your skin.

It is good to get up and move around and walk frequently. This will also reduce the amount of swelling and pain you experience. Be very careful at first, however, that you have assistance when standing up until you are certain that you are not lightheaded and are not at risk for falling.

When you go home you will typically have rubber bands on your braces, which will limit your ability to open your mouth. These may be fairly tight at first and will be adjusted to get progressively lighter over about 6 weeks following your surgery.

We will provide you with a syringe that will make it easier to feed yourself. You will be required to maintain a nearly liquid diet for about 6 weeks after surgery. This will progress from absolute liquids immediately following surgery to a very soft non-chewing diet over the weeks following surgery. After 6 weeks, you will be advanced back to a soft and then to a normal diet.

You should resume brushing your teeth to the best of your ability on the first day following your surgery. You must very only brush the surfaces of your teeth and to avoid the areas of your incisions in the fold above and below the teeth. If you do not brush your teeth, your mouth will become very inflamed and you will be at a greater risk of infection.

You will be prescribed liquid pain medications and antibiotics after surgery. It is vital that you have some food in your stomach before each time you take these medications, or they may upset your stomach or make you vomit. It is important to take pain medicines as frequently as needed to keep pain under control. If you wait to take pain medicines until the pain is more intense, it can be harder to get under control.

It is normal to have some light intermittent bleeding after this type of surgery, sometimes for several weeks. You may also have dark blood drain from your nose which is accumulated in your sinuses during the surgery. If you are having continuous significant bleeding, you should contact your doctor.

If you have regular medications prescribed by your physician that you take on a regular basis, you should resume taking these on your normal schedule unless you are instructed otherwise. You may need to contact your prescribing physician before surgery to acquire liquid versions of your regular medications until you are able to get pills in your mouth again.

It is quite normal after jaw surgery to have some pain, swelling of your face, and bruising on your face or neck. Sometimes these things can be quite severe, even for a smaller procedure. It is also normal to experience tightness of the muscles around your jaws which can make it very difficult to open your mouth fully. All of these symptoms will generally increase 4–5 days after surgery and then slowly start to improve.

Most patients will require some degree of pain medicine for about 7–14 days after surgery. Some patients who have jaw surgery will experience very prominent swelling and nasal congestion. This typically reaches its peak about 4–5 days after surgery. This can make breathing through your nose more difficult, and patients who have rubber bands on their braces will sometimes feel very anxious from this combination of circumstances. You can use saline or Afrin^® nasal spray to help clear out your nose, but you must avoid blowing your nose if you’ve had upper jaw surgery. It is important to stay calm and slow down your breathing. If you do this, and are still having legitimate difficulty breathing, you should call 911 or go to an emergency room.

You will have sutures in your mouth after surgery. All of the sutures used will typically dissolve over time. They do not typically need to be removed, but if you notice pieces of suture hanging or starting to come out of your mouth it is OK for you to trim them carefully with a small scissor. Occasionally patients will have a small incision on the cheek with one or two sutures, which the doctor will need to remove at the appropriate time.