After surgery, you’ll be in the recovery room for 2-3 hours, closely monitored by nurses. The breathing tube may stay for a few hours for airway protection. Family can visit after you’re transferred to the surgical intensive care unit (S.I.C.U.). Extensive Orthognathic surgery patients receive 24-hour supervision in the S.I.C.U. before moving to their room.
Patients who have undergone successful rigid internal fixation, particularly those who have only had lower jaw surgery and are not wired together, may be directly transferred from the recovery room to their own room or a stepdown unit.
To ensure a peaceful environment and consider your emotional well-being, we advise limiting visitors to immediate family members during the initial 7-10 post-operative days.
Swelling is normal after surgery, and its extent varies among individuals. Lower jaw surgery tends to cause more swelling than upper jaw surgery. Swelling peaks around 48 hours after the procedure and remains steady for about 4-7 days. From the second to third week, it significantly reduces. We will employ ice packs and steroids to minimize swelling, and keeping your head elevated and being active will help as well.
Nausea and vomiting may occur, but it’s not life-threatening. If you experience vomiting, stay calm and turn your head to the side to clear your mouth. Although wire cutters are available in emergencies, they are rarely needed as modern techniques rarely require jaw wiring.
In most cases, jaw wiring is not necessary after surgery because rigid internal fixation is used. Instead, patients wear light elastics between the dental arches for several months to enhance stability and comfort. Although your jaws won’t be wired, it’s crucial to follow the dietary protocol to avoid loosening or separating the screws during early healing. The plates and screws typically don’t need removal, but very rarely, if they become infected or tender, removal might be necessary.
Nighttime teeth clenching or grinding, often unnoticed, can lead to muscle and joint pain. Surgeons may recommend a nightguard and medications to reduce this habit and associated symptoms, protecting rigid fixation and preventing joint degeneration risks.
Relapse is when the jaws return to their pre-operative position, which is more likely with pre-existing conditions like joint issues, muscle pain, clicking, popping, or clenching/grinding habits. Your surgeon will discuss this and offer recommendations for a successful outcome.
Minor bleeding and increased salivation are common after surgery. Using a suction at your bedside can help clear excess fluids from your mouth. Swallowing normal saliva is safe. For those who underwent upper jaw surgery, oozing and mucus discharge from the nasal cavities may persist for up to 10 days. Avoid blowing your nose for two weeks post-surgery; let the doctor or nurse handle nasal suctioning if needed.
Drink enough fluids to have the I.V. removed. Intake will be monitored. Aim for 2-3 liters daily through sipping. Drink clear fluids from a glass; avoid straws for eating during the first week to prevent issues.
Speech improvement is unpredictable after surgery, but it gets better with repeated attempts. Speak slowly, concentrate on each word, and be patient. Most patients are understood within 24 hours. People may mistakenly speak louder, confusing your speaking difficulties with hearing loss.
Common discomfort after surgery is managed with medications. Bone grafts may cause more discomfort. Wisdom teeth removal can be more uncomfortable. Efforts will be made to keep you comfortable.
Patients without jaw wiring may have slight muscle weakness, requiring a restricted diet and elastics on braces for bite stabilization.
Earache or jaw joint discomfort may occur due to muscle spasm or surgery-related changes. Ask for medication if needed.
Post-surgery, nasal stuffiness may occur from tubes and upper jaw procedures. Manage with nasal sprays and cleansing. No blowing nose for two weeks after upper jaw surgery; use moistened Q-tips soaked in a Hydrogen Peroxide-water solution to remove secretions.
For nasal sprays, spray with force to taste the medication. Nurses or doctors can remove nasal crustaceous material. Daily evaluation of breathing. Notify nurse if buildup occurs. Humidified air or oxygen helps reduce buildup and aids in suctioning.
Early walking is encouraged, even if bone was taken from the hip during surgery. It benefits your body systems and can shorten hospital stay. Remember, you’ve had elective surgery; being physically and emotionally prepared will speed up your recovery to normal activity.
Expect post-operative depression, usually on the second or third day. It’s common after this surgery but short-lived, so don’t be overly concerned.
Expect 5-10 pounds weight loss post-surgery due to reduced appetite and dietary changes. Appetite improves within a week, weight may stabilize or increase. Some patients may be pleased with shedding a few pounds.
Patients are usually discharged 2-3 days after surgery with medications and instructions. You’ll have a diet sheet from earlier, and an office appointment scheduled within a week of discharge. If any questions or complications arise, call immediately. Resume normal activities as soon as possible.
In case your jaws are wired together after surgery, you’ll have wire cutters and a special instrument at your bedside. Jaw wiring is rare due to rigid fixation. If wired, it may last 4 days to 4 weeks, depending on the surgery complexity. Carry small wire cutters at all times for emergencies, and we’ll show you how to use them for removal.
Avoid smoking during the post-operative period as it can cause heavy staining to teeth, braces, and splint, and may slow down wound healing.
Post-upper jaw surgery guidelines:
- Avoid blowing your nose for 2 weeks.
- Keep your mouth open when sneezing to avoid pressure on cheeks and nose.
- Changes of pressure (e.g., on an airplane or elevator) can be painful.
- Sleep with your head elevated.
- Use nasal sprays as needed.
- Expect nose bleeds or runny noses.
- After unwiring, start with a liquid diet and gradually move to soft and normal foods.
- Handle nausea calmly; if vomiting, turn your head to the side to let it drain from your mouth.
- Avoid contact sports for at least 8 weeks.
- Refrain from strenuous exercises or activities causing heavy breathing.
- Carry wire cutters if your jaws are wired.
- Avoid foods, liquids, or alcohol that may upset your stomach.
- Do not use straws for the first week after surgery.