Orthognathic surgery is a surgical correction of the skeletal anomalies or malformations involving the mandible (lower jaw) or the maxilla (upper jaw). These malformations may be present at birth or they become evident as the patient grows and develops.
Due to orthognathic surgery or a jaw fracture, your jaw may be immobilized to heal properly. In order to do this, your teeth may be wired or have elastic bands placed on them to hold your jaw/bite in place. Chewing foods will create mobility between the bones that will prevent them from healing leading to infections and other serious problems which may require additional surgery, so even if your jaws aren't wired together you will generally be on a liquid diet for 4-6 weeks.
Most patients undergoing orthognathic procedures by our doctors are surprised at the lack of significant discomfort following surgery. Adult patients with moderate pain may take 600-800mg of liquid ibuprofen every three to four hours. Most patients are comfortable with this regimen. Please contact our office for instructions or if you have any questions prior to taking any medications.
For severe pain, take the medication prescribed as directed. The prescribed pain medicine will make you sleepy and will slow down your reflexes. 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, or at any time you feel the level of pain is not managed with the above medications you should call the office. Narcotic pain medications may cause constipation please alert your doctor if your are faced with this minor problem.
Do not wait for severe pain to take medication. As soon as you feel any beginning of discomfort start with the above regimen. Severe breakthrough pain is very difficult to overcome.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is very common. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until 1-2 days following surgery and will not reach its maximum until 2-3 days post-operatively. However, 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. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of gentle moist heat to the sides of the face is beneficial in reducing the swelling and stiffness. Sleep with your head elevated on two pillows for the first week.
Maintaining a healthy diet following your surgery is your primary responsibility. You must continuously feed yourself during the day in order to achieve appropriate protein and caloric intake. Feeding must be done continuously due to feeding difficulties you will experience immediately following these type of procedures.
You can reduce the risk of dehydration and keep secretions thin by drinking at least ten 8 oz glasses of fluids a day. Follow a high protein, high calorie blenderized liquid diet. Calorie and protein supplements can be used and are encouraged. Products such as Ensure, Carnation and Boost are recommended. Protein powders are more affordable and just as effective as premade caned supplements such as those mentioned above. Protein powders can be purchased at health-food stores and most supermarkets. Increased protein intake after surgery is vital for maintaining the body's protective systems and for building healthy new tissue. You will lose between five and ten pounds during the first couple of weeks as your body adjusts to the diet change. You may eat anything blenderized that has a pourable consistency. Our office also will supply you with written diet instructions prior to surgery.
Remember snacks! Juices, smoothies, puddings, yogurt etc.
For the first 3-4 days following surgery please limit your activity. It is important that you not confine yourself to bed. Try to spend most of the day sitting in a comfortable chair and taking short walks around the house. You should limit your visiting hours to 1-2 hours. Although you may feel well, you have had a major procedure and your body needs to recover. Uninterrupted rest is very important in your healing period. Do not participate in sports or strenuous activities, or return to work until permitted by your surgeon. Driving any motorized machinery or vehicle or signing any legal documents while taking pain medications is not recommended. The pain medications may cause alterations of visual perception and impair judgment.
Most often following these type of procedures, teeth must be kept together with wires or elastics after surgery. This allows the jaw bones to be held still while healing. Most of the time, however, small bone screws and plates are used to hold the bone segments together during the healing period. With the use of these screws and plates the jaws can still move slightly during the post-operative period. It must be remembered that the bones are not healed and are simply held together by the screws and plates. Therefore, we encourage a gradual progression of movement and use of the jaws, keeping in mind that complete healing process does not take place for approximately two to three months after surgery.
Following your procedure you will develop difficulty breathing through your nose. This is a transient problem that peaks at about day 3-4. Although this period can be frustrating for the patient, the instructions below will be helpful.