Post-Operative Instructions: Orthognathic Surgery

THIS PAGE WILL COVER IMPORTANT POST-OPERATIVE CARE INSTRUCTIONS FOR ORTHOGNATHIC SURGERY.

If you are undergoing this procedure, it is important to follow these instructions to ensure optimal healing and quick recovery.

MEDICATION

At your pre-surgical appointment, which usually takes place within 1 week prior to surgery, you will receive all of your post-operative prescriptions. For your convenience, please fill your prescriptions before undergoing your surgery. Your prescribed narcotic will make you drowsy. Please take your narcotic medication as prescribed. If instructed by your surgeon, you may use 800 mg of ibuprofen every 6 hours along with your prescribed narcotic. Please avoid using aspirin during your recovery. You will be taking antibiotics during your first week to 10 days following surgery to prevent a possible post-surgical infection. Please take all of your antibiotics as prescribed.

ORAL HYGIENE

It is important to keep your mouth clean after surgery, even if the mouth is sensitive because bacterial plaque and food accumulation may cause infection and can delay healing. Begin brushing your teeth and cleaning your mouth at least twice a day beginning the day after surgery. Any incisions made during surgery will be far enough away from your teeth to prevent touching them with your toothbrush if you brush carefully around your teeth and gums.

If you have been given elastics, you may remove them when brushing and rinsing. Please use the Peridex^™ oral rinse twice a day. Replace the elastics in the exact position when you are finished brushing your teeth. If an elastic breaks, replace it as soon as possible. You will be given extra elastics to replace any that might break during normal function.

It is a good idea to keep your lips moist by using a very thin layer of lip ointment, such as Vaseline^®, Blistex^®, or Chapstick^®.

SWELLING

Swelling is normal after surgery and could be a cause of post-surgical discomfort. Swelling can be reduced by applying an ice pack to the side of your face for 20 minutes, then transferring it to the opposite side for another 20 minutes. Do not freeze the skin. Icing is effective for the first 24 hours only; do not be alarmed if facial swelling increases 36–48 hours after surgery. If you have been given a Polar Care machine, disregard the above instructions and follow the instructions you were given in the hospital/surgical center for the Polar Care machine.

It is not uncommon to experience a low-grade temperature in the first day or two following surgery; it will resolve by itself. An ice pack is also useful following your surgery if you experience muscle spasms or to soothe your face if it is feeling warm. We also recommend sleeping with an elevated head during the first week and covering pillows with a towel; it is not uncommon for blood clots to break down at night.

EATING

Following your surgery, you will be placed on a non-chewing soft food or liquid diet. Your doctor will provide you with in-depth information regarding your diet prior to surgery. It is important that you maintain balanced nutrition despite eating limitations. Dietary supplements such as Ensure^® or Boost^® can help ensure you receive the necessary nutrients that your body needs. If you are allowed soft food options, please do not bite into anything with your front teeth even if it feels soft. This will prevent you from placing excess pressure on the bone screws and plates that are holding your jaw in place.

NASAL SPRAY

Many patients who undergo upper jaw surgery experience nasal congestion and may use a nasal spray to clear the sinus passage. Remember, the sinus passage does not go straight up, and it is necessary to tilt the top of the bottle downward once inserted in the nostril and squirt according to the spray instructions. You should taste the spray in the back of your throat. Administer nasal spray into both nostrils. You should only use nasal spray once every 12 hours. Do not blow your nose or participate in heavy lifting or straining of facial muscles for the first 2 weeks after surgery.

ACTIVITY

Patients who remain active during their recovery period recover much more quickly than those who remain inactive. You are encouraged to ambulate 3–4 times a day for the first week of surgery. You will probably experience the ups and downs of the recovery period during the first week after surgery; just remember, this is normal! Almost everyone has second thoughts about their surgery during the first week. Hang in there; the second week will be much better!