After Orthognathic Surgery

IMPORTANT: No driving for 72 hours after surgery and while taking narcotic medication.

Call Upland Office Phone Number 909-982-8888 with any questions.

Bleeding

  • Periodic bleeding is expected after oral and facial surgery for the first week. This should not be excessive and will most likely stop within minutes of starting.
  • With upper jaw surgery, you may experience blood from the nose for the first week. Do not blow your nose for 2 weeks.
  • Do not rinse or spit for 24 hours after surgery.
  • Try to keep your tongue away from the surgical area as to not disturb the sites and blood clots.
  • Bruising is normal after jaw surgery and will usually last for 2-3 weeks. It may even extend down into the upper chest area.

Medications

  • For mild discomfort take Tylenol or Ibuprofen every 3-4 hours.
  • For severe pain take the prescribed medications as directed. A full stomach minimizes nausea associated with some prescription medications.
  • Application of an ice pack can also help relieve some discomfort. Use for the first 48 hours only.
  • If a pain pump was used, please refer to the On-Q Pain Pump brochure.
  • Please finish all antibiotics as directed. Women please note: Some antibiotics may interfere with the effectiveness of birth control pills. Please check with your physician.
  • If a decongestant was prescribed, complete the prescription.

Swelling

  • Swelling is a normal response to any surgery. Swelling peaks on the second or third post- operative day. Trismus (swelling) of the muscles may cause difficulty in opening your mouth for a few days.
  • Ice packs applied to the sides of the face will help minimize swelling. Use ice packs for the first 48 hours; apply ice 20 minutes on and 20 minutes off. Bags of frozen peas work well.
  • After the first 48 hours, discontinue ice packs and begin warm compresses. A moist wash cloth, hot water bottle, or uncooked rice in a tube sock may be warmed in the microwave. Be sure to touch test it before to avoid burning yourself.
  • Keep your head elevated for 2 weeks after surgery. This will help your sinuses drain and minimize swelling.

Diet

  • In most cases today, the teeth are not wired together after jaw surgery.
  • There is frequently some temporary numbness in the upper and/or lower lips. Numbness, facial swelling and soreness can make eating and drinking a difficult task at first.
  • No straws, spitting, smoking, or carbonated beverages for 3 weeks after surgery.
  • No abrasive foods such as popcorn, chips, seeds or nuts.
  • Use of a feeding syringe with tube attached may make it easier for you to get something in your stomach. Ask us for help with this.
  • Use a cup to drink. If you have difficulty with this, try doing it in front of the bathroom mirror over the sink. You will find this gets easier each time you drink. Taking adequate amounts of fluids is essential after surgery. This can consist of fruit juices, milk or water. You may also use a sports-type squirt bottle to squirt liquids into your mouth.
  • Initially it will be difficult to eat adequate amounts of food in only three meals per day. Try to eat five to six meals per day, eating smaller portions each time.
  • For the first 10 days, your diet will be essentially non-chewing. This can be blended food or soft foods that don’t require chewing. This can include creamy soups, milkshakes, smoothies, baby food, yogurt, pudding, cream of wheat or any blended food. When using the blender, use broth to help smooth consistency.
  • After the first 10 days, you can gradually add foods that require minimal chewing. Foods like mashed potatoes, pasta cut into small pieces, scrambled eggs, pancakes and rice.
  • After 3 weeks, foods like hamburger, soft chicken and fish can be gradually added into your diet. It is normal for your jaw to tire easily. This will continue for 2-3 months.

Hygiene

  • Great care should be exercised to brush your teeth and wires after each meal, at least 3 times a day or after every meal. Cleaning your teeth cannot be overemphasized. It is very important to keep the surgical sites clean to prevent infection. Use a soft baby toothbrush to clean all areas in the mouth.
  • Rinse mouth gently with a solution of one-half teaspoon salt dissolved in a glass of warm water 3 times a day. Occasionally, a prescription mouthwash is given. Use as directed. Avoid over-the-counter mouthwashes.
  • It is a good idea to keep your lips moist by using a thin layer of lip ointment, such as Vaseline, Blistex or Chapstick.
  • You may have a plastic splint wired to your upper jaw, keep that area clean as well.
  • You may be asked to use elastics. Elastics may be removed while eating and for hygiene and then replaced as directed by your surgeon.
  • Clean around skin sutures using a 50/50 solution of water and peroxide with a cotton swab. Then apply Neosporin or a triple antibiotic ointment on to the site. Do this twice a day.
  • Your surgeon will remove all bandages that have been placed at your post-operative visit.

Hip Incision (Iliac Crest Harvest), Shin (Tibial Harvest), Scalp (Cranial Harvest)

  • Use ice packs for the first 48 hours; apply ice 20 minutes on and 20 minutes off. After the first 48 hours discontinue ice and begin warm compresses.
  • A dressing may be have been placed over the incision. If so, it will be removed by your surgeon at your post-operative visit.
  • If there is no dressing present; clean incision using a 50/50 solution of water and peroxide with a cotton swab. Then apply Neosporin on to site twice a day.
  • If you have skin incisions, you should not bathe or shower for 7-10 days after surgery. You may take a sponge bath to wipe your skin clean, keeping the incision areas dry. No swimming for 3 weeks.

Activity

  • No strenuous activity or heavy lifting for 3 weeks after surgery.
  • Limit exercise to walking for the first 3 weeks. Walking is encouraged.
  • You may return to light housework or daily activities during the first week. Slowly resuming your activities will help speed your recovery and should make you feel better.
  • No contact sports or sports involving a ball for 12 weeks. Remember your jaws are not fully healed for 8-12 weeks. Be careful.

Remember, postsurgical progress is sometimes uncomfortable and may occur slowly. With some determination and attention to these instructions, you will find that your postoperative recovery will occur as quickly as possible.

Please feel free to contact us with any questions that you may have. Dr. Gilbert is available 24 hours a day at Upland Office Phone Number 909-982-8888.