After Orthognathic Surgery

POST-OPERATIVE INSTRUCTIONS for ORTHOGNATHIC SURGERY 

INSTRUCTIONS for CARE of WOUND The pressure bandage (Jaw Bra) should be worn continuously for about 48 hours.  After 48 hours, the bandage may be used as a jaw “support” as needed.  Many patients find that it is useful for several days until jaw strength improves.  ICE or cold packs are recommended for the first two days after surgery… then, you may switch to moist heat packs.  Lip rash is quite common after this type of jaw surgery, and it is recommended that lip therapy be used.  (Lip therapy was provided in your bag.)

FACIAL SWELLING is quite common, and may continue to slowly increase for up to four days before decreasing.  Sleeping with your head elevated about 30 degrees (two pillows) helps to minimize the swelling and also helps to decrease it in the first two weeks following surgery. 

ORAL HYGIENE is difficult, but very important to manage following surgery.  Use a small, soft toothbrush (provided in your bag) and do the best that you can without disturbing the incisions .  The use of an irrigating syringe (provided in your bag) is also helpful, as well as frequent mouthwashes.  Avoid the use of a water pick for at least two weeks following surgery.  Nasal stuffiness is common, but it is recommended that you NOT BLOW YOUR NOSE for at least 10 days following surgery.  Use saline spray as often as you like, but avoid the use of sprays such as Afrin except at bedtime, and only for approximately 3 days.       

DROWSINESS or easy fatigue is common for several days following surgery and maybe the result of anesthesia used, a slight temperature, or effects of medications prescribed.  Check your temperature daily for at least 5 days… a mild elevation is normal, but a temperature over 102 degrees is NOT normal and you should notify Dr. Bart D. Williams at Greenville Office Phone Number 864-458-9800. Regarding medications, take only as directed and try to minimize the use of “as needed” drugs.  Do not drive until the use of pain medication is no longer needed.  

ACTIVITY should be minimized for at least 7 days following surgery.  However, spending as much time as comfortably possible out of bed sitting up and moving around the house helps speed recovery to daily activities.

WEIGHT LOSS following surgery is normal.  Your weight should stabilize after 7-10 days, and should return to normal in about three weeks. Dieting is generally not recommended immediately following surgery because nutrition is critically important for wound healing.  As a general rule regarding diet, begin with food processed in a liquid fashion (See pamphlet provided in your bag Dinner through a Straw).   You may begin to chew soft foods such as noodles, vegetables, or fish, as soon as you can bite AND exert pressure on your teeth without discomfort (usually 14 days). 

ORTHODONTIC ELASTICS will be placed, prior to hospital discharge, to guide your jaw and teeth into their new positions when you bite.  Additionally, the surgical splint used in surgery may be left wired to your upper teeth for the first couple of weeks or longer to support jaw segments during healing and to guide teeth into their new position.

OPENING AND CLOSING YOUR JAW   The ability to close your jaw and find your new bite will be difficult for the first few days after surgery… however, within about 10 days, it will become difficult to open.   Your jaw will seem stiff and your mouth opening will be limited.  This is normal and it takes several weeks to return to a range of motion similar to before surgery.  As soon as you can open to about one inch, and as soon as most of the soreness has resolved, you will be able to return to your orthodontist to begin post-operative treatment (usually within 3-4 weeks). 

NUMBNESS is quite normal after surgery, and you may notice tingling, itching, or even a burning sensation on your lips and around your mouth within a few days.  It often takes several weeks or even months for the feeling to return too normal. 

DIFFICULTY SLEEPING should be expected for the first few days following surgery, primarily due to the discomfort associated with your jaw muscles, nasal stuffiness, sleeping on your back, and because of some of the medication side-effects.  This problem rarely lasts longer than a few days and Dr. Williams can prescribe a mild sleeping medication if needed. 

MOOD ALTERATION   / depression can occur following surgery.  The anesthetic, the surgery, and side effects of the prescribed medications all contribute to create an initial psychological “let-down” during the first week after surgery.


Post-operative x-rays will be made and we will help you clean your teeth and your mouth.  We will also get your weight so that we can watch your nutritional status during the first few weeks after surgery.  If you have any questions or if any problem occurs, please contact our office 24 hours a day at Greenville Office Phone Number 864-458-9800 or 864-442-6564.  If after normal office hours, Dr. Bart D. Williams III will be paged.  Please allow time for Dr. Williams to return your call.

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