After Orthognathics (Jaw Surgery)
Orthognathic surgery is performed in the hospital operating room under general anesthesia. Most patients will
stay in the hospital for 24-48 hours after surgery for initial post-operative care. After discharge, the patient will normally be seen in the office within 72 hours for post-operative x-rays and evaluation.
The amount of pain and discomfort experienced by patients after orthognathic surgery varies case by case.
However, considering the nature of the surgical procedure performed, many patients relate their pain levels immediately after surgery to be lower than when they had their wisdom teeth removed. This perception of pain is due to the numbness in the patients’ face, lips and gum tissue from the sensory nerves being stretched during surgery as well as being administered IV pain medications. Prior to discharge from the hospital, patients are transitioned to oral pain medications, typically a combination of an anti-inflammatory and narcotic. Patients are advised to use the narcotic only as needed, which is typically 1-2 weeks.
Post-operative swelling causes most of the discomfort for patients after their surgery. The amount of swelling
each patient has is variable. As with most surgeries, you should expect swelling and discomfort to peak 48-72 hours after surgery. To help with this discomfort, a large dose of IV steroids are administered. Pressure dressings
and ice packs are also used, but expect some bruising to accompany the swelling. Both swelling and bruising will gradually resolve over the course of 2-4 weeks.
Many patients will exhibit intermittent oozing from their incisions for up to one week after surgery.
Rinsing with warm salt water helps cleanse the area and keep it clean as well as rids the mouth of any undesirable tastes. Patients that have had upper jaw surgery will often experience an intermittent bloody nose for several days
after surgery. These patients may also notice blood clots draining from their sinuses for several weeks as well. To help stop the drainage, pack the nostrils with gauze or cotton packs. Patients with stuffy sinuses can use a humidifier or sit in a steamy shower to help facilitate the drainage. If you experience excessive bleeding, please call our office.
For most orthognathic surgery patients, we ask you to refrain from any food requiring chewing for 6 weeks.
This includes any food that cannot be easily broken up with a fork. It is very common for patients to lose weight after surgery due to this strict non-chew diet. To keep your strength and energy up for the healing process, you will likely
need to eat multiple small meals throughout the day. Dietary supplements such as boost are often helpful. It is also
very important for the healing process that you drink plenty of fluid.
Many patients experience a sore throat for several days after surgery. This is typically related to the
breathing tube used for anesthesia during surgery. In most cases the sore throat resolves during the first week.
In most instances, long-lasting dissolving stitches are used. This particular type of stitch will typically
start to come out after 10 days. However, if a stitch or knot is bothering you after 1 week, you may simply cut it off or call the office to have it removed. These stiches are evaluated at your post-operative visits.
Most orthognathic surgery patients have small titanium plates and screws inserted at the time of surgery
to help hold the bones in place. These plates are under the gum tissue and are usually permanent. In addition, some patients who have had upper jaw surgery will have a plastic splint fixated to the roof of their mouth or between their
teeth to provide additional stability. This splint is removed after 6 weeks. Elastics (or rubber bands) are usually placed at the time of surgery to help train you to bite in your new position as well as help maintain the position of
the jaws. The number and position of elastics will vary and are changed throughout your recovery.
Many patients experience numbness in their lips, chin, and gum tissue, roof of the mouth and under their eyes
after orthognathic surgery. This is usually a temporary condition which gradually decreases over the course of 2-4 months. However, there have been cases of patients who experience permanent numbness or tingling sensations
distributed in one or more of the affected nerves. Most patients with this condition adapt quite well without any functional problems.
You will be prescribed an antibiotic, pain medication, anti-inflammatory and an antibacterial mouth
rinse. You will be given specific instructions on how to use each medication prior to discharge from the hospital. Please call our office if you have any questions about these instructions.
Most patients require 2 weeks off from school or work after orthognathic surgery. Due to the effects of
anesthesia, general weakness from the surgery as well as potential drowsiness from the pain medication, you should be prepared not to drive for 1 week after surgery. You must also avoid strenuous physical activity and contact sports for 6 weeks. Our office will provide you with any work/school/sport release forms you require during this time.