Post-Operative Instructions: Orthognathic Surgery

Post-Operative Instructions: Orthognathic Surgery

These instructions are intended to help you recover with confidence following your discharge from the hospital.

THE FIRST FEW DAYS

Swelling

  • You were given medication in the hospital to help minimize swelling. Swelling will likely peak 48–72 hours after surgery and decrease from that point.
  • Keeping your head elevated by resting in a recliner or sleeping with an extra pillow will help limit swelling.
  • Using ice packs for the first 24–48 hours will also help limit swelling.

Congestion/Secretions

  • Your nose may feel congested after surgery on your upper jaw. Please do not blow your nose as this increases the pressure in the surgical site.
  • Congestion is at its peak usually between day 3 and 5.
  • Plan to use a vaporizer in your room.
  • Your surgeon may have discharged you from the hospital with decongestant medications; follow the directions on the bottles.

Pain

  • Your surgeon gave you a prescription for pain medication. It is expected that you will need a narcotic pain medication for a few days following your jaw surgery. If you are not experiencing any pain, then you do not need to take the medication.
  • Tapering down on your medication is also encouraged. If your pain medication is not adequate or if you are experiencing dizziness or headaches following pain medication, please call your surgeon.

Nausea and Vomiting

  • Call your surgeon if you experience nausea following surgery or with pain medication use. Medication is available to help with this.

ORAL HYGIENE

Good oral care after surgery keeps the surgical area clean and helps prevent infection. It also helps promote a feeling of comfort to have your mouth clean. Oral care begins within 12 hours after surgery and must be continued when you go home.

Rinses

  • Saline (saltwater) rinses should be done every 4 hours, or more often if needed. Use 1/4 teaspoon of table salt dissolved in 8 ounces (1 cup) of warm water for the saline rinses.
  • Avoid the use of strong mouthwashes. In addition to this, you will have a prescription for a bottle of chlorhexidine (Peridex™) to use as a rinse twice daily. Please use this for the first 7–14 days after surgery.

Tooth brushing

  • Brushing should be done with a soft, small toothbrush.
  • Your swollen lips will make it more difficult for you to be aware of the saliva that collects in your mouth. Thus, you may experience some drooling. This is only temporary.
  • Your lips, particularly the lower lip and some of your gum tissue, may feel numb after surgery. Brush carefully and keep the toothbrush on your teeth.

EMOTIONAL SUPPORT

You may find that the first days and weeks after surgery are difficult both physically and emotionally. At times, you may wonder why you decided to go forward with surgery. These feelings are common and usually quickly subside as you begin to feel and look better. Be prepared to make adjustments in the following areas:

Communication

  • You will likely have elastics on between your upper and lower teeth.
  • Talking may be frustrating for you, especially with elastics on, but you will not hurt anything by talking.
  • You may want to write on a tablet or whiteboard to communicate during the first few days after surgery.
  • Talking will become easier once facial swelling decreases.

Reaction to your appearance

  • Jaw surgery changes your appearance. If your appearance is markedly different after surgery, you can expect family and friends may be surprised by the difference.
  • Instead of having to explain your surgery to each person you encounter, let family and friends know ahead of time that you will look different following surgery and that their support will mean a lot to you.

DIET

Adequate nutrition is important right after surgery. For a few days after surgery, you will likely not feel hungry or thirsty. It is important to remain well-nourished and well-hydrated.

  • Plan for a puréed diet for the first 2–4 weeks after surgery. After the first 2–4 weeks, you may advance your diet to things like mashed potatoes, scrambled eggs, and soft pasta. The timing of your diet advancement will be discussed in detail with your surgeon at follow-up visits.
  • Maintaining adequate fluid intake is critical to your health and well-being.
  • Caffeine products will dehydrate you and are not recommended for a couple of weeks after surgery.
  • Alcohol can make you nauseated and impair your judgment; this places you in danger.

ACTIVITY

Beginning the day after surgery, you will be encouraged to get out of bed to walk or to sit in a chair. When you get home it is important to move around.

  • Expect to be fatigued from simple activities.
  • It is okay to shower — the steam will help with nasal congestion — but a long hot shower could make you dizzy!
  • Make sure that several times a day you are getting up and moving around, changing position and taking deep breaths.

MEDICATIONS

The medications that you take home with you after your jaw surgery may include an antibiotic, a decongestant, and pain medication. Your medications will likely be in liquid form. If you have other medications that you normally take your surgeon will discuss with you how to take those medications with tight elastics in place.

  • Antibiotics: Continue until the bottle is empty. Do not quit halfway.
  • Pain Medicine: Usually it is necessary to take opioid (narcotic) pain medication in a scheduled fashion (every 4 hours) for the first 24 hours and as needed thereafter. Remember that narcotics can make you drowsy, so no driving, swimming, operating machinery, or drinking alcoholic beverages while you are taking them.
  • You may wean yourself off the opioid medication and substitute with 500 mg of acetaminophen (Tylenol®).
  • If directed to do so, you may also use ibuprofen, 600 mg every 6 hours while awake, for the first 4 or 5 days.
  • Peridex™ (chlorhexidine) mouth rinse: Use twice daily for 2 weeks after surgery.

Call your physician promptly if you experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Pain that worsens or is not relieved by medication
  • Discharge or foul taste in your mouth
  • Nausea or vomiting

Please call Columbia Basin Oral & Maxillofacial Surgeons if you have questions or concerns. Our office number is (509) 783-7600. We are available 24 hours a day.