After Orthognathic (Jaw) Surgery
Immediately Following Surgery
- Admission to the hospital is necessary after the surgery for careful observation and nursing care.
- Significant facial swelling is expected after the surgery which may last 1-2 weeks. Place ice packs to the sides of your face to help with pain and swelling.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. If profuse bleeding occurs in the mouth or through the nose, call our office for further instructions.
Swelling around the mouth, cheeks, eyes, and sides of the face is expected. This is the body’s normal reaction to surgery. The swelling will become apparent immediately following the surgery and will reach its maximum 2-3 days post-operatively. The swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 48 hours, ice has no beneficial effect. 2 days following the surgery, moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Prescription pain medication will be given to you after you are discharged from the hospital. For severe pain, the prescribed medication should be taken as directed. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Liquid diet (or non-chewing diet) is frequently needed while your jaw bone is healing. Our staff can provide suggested diet instructions. Nourishment should be taken wisely. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals.
CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up slowly before standing.
Good oral hygiene is essential to good healing. The day after surgery, use the prescription oral rinse as directed; after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Be gentle with brushing initially. The day after surgery you should begin rinsing at least 4-5 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent or resolve infection. Discontinue antibiotics use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.
Nausea/vomiting is common after this type of surgery. In the event of nausea/vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on coke, tea, or ginger ale. You should sip slowly over a fifteen-minute period. Contact our office immediately if nausea/vomiting continues.
Due to close proximity to the infraorbital nerve, mandibular nerve, lingual nerve and buccal nerve, altered sensation to the upper lip, lower lip, tongue and cheek is expected following the surgery. The timing of recovery may be days to months or longer depending on the type of injury. Short duration injuries (neuropraxia) usually involve brushing against or bruising the nerve and recovers in hours to days. Intermediate injuries (axonotmesis) involve compression or stretching of the nerve and usually recover in weeks to months. More involved injuries (neurotmesis) involve separation of some or all of the nerve fibers and may cause permanent numbness. Surgical repair may also be needed. We will monitor and advise you should any of these events occur.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, contact our office immediately.
- You should be careful going from the lying down position to standing. You could get light headed from medications.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
- Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
- Brushing your teeth is okay – just be gentle at the surgical sites.