|Home Care Instructions » Jaw Surgery (Orthognathic Surgery)|
|Please read these instructions several times and make sure all of your questions are answered prior to surgery. We will give you specific instructions if we make any changes in these directions.
Since you have just undergone a major surgical operation, use good common sense in the first 7 to 10 days after surgery to restrict your normal activities, exercise regimens, and any activity requiring heavy lifting or straining.
It is acceptable to do some light walking on the day of surgery. Jogging and light non-contact exercise should not be resumed for ten days to two weeks. You can resume more strenuous activities as your condition improves.
You may be up and around on the day of surgery but some natural fatigue may persist for three to ten days due to the normal effects of the anesthesia and surgical procedure.
Use your best judgment and do not ignore signs from your body of overdoing.
If you have a facial pressure dressing, ice packs will not be efective. After the bandage is removed on the day after surgery, you may use ice packs (a few ice cubes and a half cup of water in a zip-lock bag, or frozen peas in a plastic bag) for the second day while awake. Do not use the ice packs continuously. Use them for thirty minutes, then leave them off for thirty minutes. Do not use ice after 48 hours unless you are told to do so by Dr. McBride
It helps to keep your head elevated on two pillows during sleep for the first 2 days. This keeps your head higher than your heart and helps prevent swelling and facilitates the resolution of swelling. Do not sleep face down. Sleep on your back or side.
Facial and neck swelling and bruising are normally present after jaw surgery, but the degree of each varies widely from patient to patient. The worst swelling usually occurs on the third day after surgery. Do not be concerned if you have more or less swelling than others who have undergone the "same" operation. Generally, most patients appear quite socially acceptable within 7 to 10 days following surgery.
Your lips, gums, palate and teeth may feel less sensitive than normal for several months. Sensation usually returns as healing progresses.
Any unexplained pain, facial swelling, bruising or fever should be reported to us immediately.
Facial Pressure Bandage
If you have a facial pressure bandage, it will feel tight on the day of surgery. The pressure is very effective in preventing bruising and swelling. You will tend to bruise in your neck below the bandage. You should remove the bandage on the day after surgery and not wear it any more.
In our office prior to surgery you received prescriptions for antibiotic pills, an antibiotic mouthwash (Periodex) in some cases, a steroid to reduce swelling, and two different pain medications. The antibiotic must be taken until it is all gone.
Start the steroids when you get home, but remember not to take any before you go to bed. It may keep you awake. One pain medication (oxycodone) is for severe pain, and the other (hydrocodone) is for moderate pain. Take the appropriate medication as needed for discomfort. It is important that you take all medications as directed, and do not take them on an empty stomach.
A good diet after surgery is an important part of your healing process. It is important to stay on a very soft diet for approximately 1 month: avoiding foods such as corn chips, beef, chicken, pork (except pureed), raw vegetables, pizza, salads, hard breads, etc. Your diet should consist only of foods that have a consistency of "mush".
You will probably not feel like eating even very soft food for the first few days. So you must drink plenty of fluids to prevent dehydration. Drink at least two quarts, 64 ounces, of fluid daily.
If you have difficulty drinking, and cannot drink at least 64 ounces each day, please call Dr. McBride. If you get dehydrated you will feel weak and nauseated, you may get a low-grade fever, and you may swell more than normal.
You should crush all food with a fork before eating so that it is the proper consistency. Select foods that are very soft and require little chewing, and foods that are high in carbohydrates and protein such as pasta, eggs, well cooked vegetables, soups, yogurt, potatoes, protein drinks (Carnation Instant Breakfast, Ensure, Boost, Atkins diet drinks, etc.), hot dogs, ice cream, milk, soft cheese, etc.
Some patients may experience nausea following surgery. This is usually due to dehydration from not drinking enough fluid. You must drink at least 64 ounces of fluid each day. Nausea may also be attributed to the anesthesia, the pain medication or other factors. A liquid antacid such as Maalox or Mylanta will usually relieve the nausea if it is not caused by dehydration.
You may have a sore throat for a day or two. Sore throat lozenges may help to relieve this discomfort. You may have some nasal irritation from the anesthesia tubing. Use a nasal spray such as Afrin for nasal congestion. A small amount of Vaseline applied to each nostril a few times each day will help to keep the secretions from drying out.
If you have an elastic bandage around your head after surgery, you should remove it on the day after surgery. If you have had lower jaw surgery there will be two small incisions on the skin at the corner of your lower jaw that were used to place screws to stabilize your jaw during healing. These incisions will be protected with sterile tape. Please leave the tape on these areas until your postoperative office visit. The tape and sutures will be removed at your first visit.
You may wash your hair and face at any time after surgery. When drying your face, gently blot the sterile tape dry, being careful not to pull or rub the incisions.
If you have had upper jaw surgery, you may notice sinus congestion and drainage. Dark, bloody nasal drainage may be noted during the first few days when you tip your head forward. This is not active bleeding, but is blood that remained in the sinuses after surgery. The drainage is good because it helps to clear the sinuses.
Do not blow your nose hard for the first week because you may force air into your cheeks. Hold the tissue away from your nose and blow very gently. If you do blow air into your cheeks it may feel uncomfortable for a few minutes, however it is not a problem because the body will absorb the air within a short period of time.
Good oral hygiene is very important after surgery. Brush gently after every meal and snack. An electric tooth brush is excellent, but do not use a Water Pik. The sutures in your mouth will not be disturbed by brushing. If the limited mouth opening is a problem when brushing, small children’s toothbrushes are available. Swish and spit out a tablespoon of the antibiotic mouthwash three times a day for two weeks.
Elastic bands may be hooked to the upper and lower orthodontic appliances to guide your teeth into the best position. We gave you a supply of elastic bands at your pre-surgery office visit. You should wear the bands 24 hours a day until instructed to change. Apply new elastics each day. You may remove the bands during meals and when brushing your teeth. Be sure to replace the bands.
Carmex, Blistex, Vaseline lip moisturizer, or a similar product, will help soothe your dry, chapped lips.
You may have some swelling in your cheeks, lips, chin and around your nose. Bruising may develop a day or two after surgery. After the 4th day apply a dry electric heating pad to the area for 30 minutes several times each day. Do not use a microwave heating pad.
You may not be able to open your mouth widely for several weeks. If necessary, we will give you exercises that will lengthen your muscles so that you can open easily and comfortably.
If you have any concerns, please do not hesitate to call our office. Most questions after surgery can be resolved with a phone call. 972-566-4900