Helpful Tips for Success in Recovery after Surgery

There are many conditions that lead a patient to pursue elective jaw surgery including difficulty chewing/biting food, malocclusion (open bite or deep bite), recessed chin, protruding jaw, lip strain, and obstructive sleep apnea. While much of the success with surgery hinges on skilled orthodontists and oral surgeons, there are components in the post operative phase that depend primarily on the patient. This blog focuses on helpful tips after this life-changing surgery.

In the first several weeks following surgery, the patient should limit their physical activity. Although you may feel well overall, it is important to remember that you have had a large surgery and your body needs time to recover. Find a comfortable, quiet area of your home to rest with your head elevated to an angle of 30 degrees (i.e. a recliner, elevated mattress, or multiple pillows in the bed). You may shower as usual without restriction. Do not participate in sports/strenuous activities or return to work until permitted by your surgeon. Most patients on average take off a minimum of two weeks from work/school for the recovery phase.

DIET: A strict soft, non-chew diet is required in the initial six weeks of healing. Under no circumstances are you permitted to chew during the first six weeks. The act of chewing causes negative forces on the plates and screws used to fixate the jaw(s) in their new position. This cannot only delay healing, but also cause plate/screw failure resulting in additional surgery and additional fixation in the operating room. You doctor will guide you during the first six weeks and provide you with food items that are acceptable to have. 

Adequate hydration is also key throughout the healing process. There are times that a patient does not drink enough due to pain or swelling. When this happens, pain management becomes more difficult, nausea increases, and the patient feels overall much worse. A patient should be drinking at least 8 glasses of liquids (8 ounces per glass) to stay hydrated.

PAIN MANAGEMENT: Surprisingly, many patients have little or easily managed pain after surgery due to numbness at the surgical site. Despite this, in the first several days after surgery, it is very important to have a pain management schedule established. Taking medications on a strict schedule that can easily be programmed into your smartphone will remove any stress that you may have with this process.

BLEEDING: It is normal to experience some bleeding from the surgical sites and incisions for the first 24 hours. Mild bleeding or blood-tinged saliva should not raise any concern. If your bleeding is excessive, then you should contact the doctor on call for further instruction. Changes in head position, standing too quickly, or uncontrolled pain are often additional causes of bleeding.

ORAL HYGIENE: As with any surgery, it is extremely important for you to keep the surgical site clean, which in this case is your mouth. You should brush your teeth twice daily and rinse after meals. Due to swelling and limited opening, brushing will be difficult the first week but absolutely necessary. Keep your braces clean as well. As the swelling decreases, oral hygiene will become easier. Rinse your mouth thoroughly with warm salt water (8 ounces of warm water with 1 teaspoon of salt stirred in) or the prescription mouthwash prescribed by your doctor starting 24 hours after surgery. Avoid the use of a high pressure WaterPik or electric toothbrushes during the initial healing phase as these can disrupt sutures.

SWELLING/BRUISING/NUMBNESS: Swelling is normal after surgery. This swelling will increase in the first 3-4 days and can be quite significant. As the swelling increases there is usually an increase in pain. Applying ice to both sides of your face in the first 72 hours after surgery can help manage swelling and also assist with pain.  Warm, moist heat can also be helpful after using the ice for the first three days. The swelling will gradually reduce with time, but some areas may take 3-4 weeks to return to normal.

It is normal to have some bruising at the surgical sites. This usually takes several weeks to resolve.

There are sensory nerves that are stretched and retracted during surgery. These nerves provide feeling of the facial region where the surgery was performed. Numbness is very common and can last for many weeks after surgery. The feeling will gradually return with time, but in rare circumstances the numbness can be permanent.

NASAL BLEEDING and CONGESTION: For upper jaw surgery, light bleeding is common and to be expected. When this occurs, it can be managed with a combination of Afrin nasal spray and tilting the head back and applying light pressure to the nose. The Afrin nasal spray should be used sparingly for only 1-2 days as needed. Congestion and sinus pressure is also very common. Unfortunately, this stuffiness must resolve on its own and usually takes several weeks to return to normal. Avoid use of saline nasal sprays and Breathe Right nasal strips. Strict Sinus Precautions must be followed during the first 2-3 weeks. These precautions include NO smoking, NO straws for drinking, NO heavy lifting, NO swimming, NO blowing your nose, open mouth sneezing only (do not plug your nose when sneezing)

Ultimately, you surgeon will help guide you through the post operative recovery phase. Elective Jaw Surgery is a huge undertaking that yields amazing results for patients with conditions of the jaw that cannot be corrected with just braces/orthodontics. The surgeons at Conestoga Oral Surgery work side by side with many of the local orthodontists to offer you this service. Visit our website to learn more about Orthognathic Surgery and feel free contact us to schedule a consultation with one of our Board-Certified Oral Surgeons today.