Orthognathic Surgery
Home Care Instructions

What To Expect The First Week

Swelling

Expect significant swelling. Double jaw surgeries will swell more. It will maximize during the 1st week and diminish thereafter. Keep your head elevated above the level of your heart at all times. Do not lay flat. Sleep in a recliner if possible or propped up with three pillows. Ice should be used for the first 48-72 hours. You will be given a head wrap with ice packs. You may use the ice pack for 20 minutes at a time, and then remove to give the skin some rest from the cold. Direct placement of ice to the skin for prolonged periods of time may produce a burn. Remember, your face will be numb. You will be given some form of steroid to reduce swelling, usually an injection prior to leaving the hospital. Your nasal passages will also be swollen resulting in congestion and difficulty breathing through your nose. Over the counter decongestants, expectorants and nasal sprays will help. A steam humidifier placed next to you at all times will also make you feel better. Similarly, some patients feel better sitting in a steamy shower. Heat in the form of a warm moist wash cloth may be used after 72 hours. You may experience “rebound swelling” near the end of the first week as the effects of the steroids wear off and you begin to use heat. This is a minor increase in swelling and should not be of concern.

Bleeding

Minor oozing from the incisions inside of the mouth should be expected in the first 72 hours. Upper jaw surgeries usually experience some minor trickling of blood through the nose. Although less common, lower jaw surgeries may experience this also due to the tubes used during surgery. This should not be concerning. Nasal sprays and decongestants will help with this. Your surgeon should be notified for a sudden or prolonged gush of bright red blood. Dark blood clots may be coughed up or expressed through the nose toward the end of the first week for upper jaw surgeries.

Bruising

Expect bruising along with swelling. The bruising should begin to dissipate as the swelling subsides. The bruising may travel in the skin as it dissipates. It will likely change colors from black/blue/purple, to green, to yellow and may travel down the neck to the upper chest. This is normal and will resolve in 1-2 weeks. Firm, swollen, painful bruising (hematoma) should be reported to your surgeon immediately.

Numbness

The numbness the face and lips may persist for weeks, sometimes months. This is a normal outcome of this type of surgery. Usually upper face and lip sensation resolves before the lower face and lips. Younger patients resolve faster. Motor nerves are usually NOT affected-you should have normal face and lip movement. Ask your surgeon about this outcome if you have further questions.

Activity Level After Surgery

  • Avoid any strenuous physical activity for 1 week.
  • You may return to school or light duty work (non-physical labor) within a week of the surgery or as tolerated per your symptoms.
  • Although you just had surgery, we recommend you do not stay in bed while awake, to minimize the chances of leg clots.
  • Try to transfer to a chair instead and walk throughout the house. Try to be as active as possible.
  • The swelling will worsen over the next 3-4 days after surgery and is expected. The swelling will begin to subside shortly thereafter.

Diet

A full liquid diet should be enforced for 6 weeks following surgery. Although you are not allowed to chew, it is very important to remain hydrated. You will be provided with a soft diet recommendation sheet.

Hygiene

You may remove elastics for hygiene, but replace them as instructed by Dr. Sanovich. Use the prescribed mouth rinse 2-3 times per day for the first week. Use a baby sized, soft bristled toothbrush to clean the teeth, splint and adjacent gums (avoid the sutures and wounds) at least 2-3 times per day. Keep the splint as clean as possible, especially the area behind the upper teeth. Keeping the mouth clean will also help prevent a wound infection. The sutures should start to dissolve in the first week as the gum tissue starts to heal. You may rinse with warm salt water often to help soothe the wounds.

Avoid mouth rinses with alcohol (a majority of commercial OTC mouth rinses) as they may burn and irritate the healing wounds. Avoid smoking as it will slow or prevent healing and may result in an infection. Avoid directing water picks to the incision wounds in the first week as fluid may become trapped in the wound.

Pain Management After Surgery

You will be prescribed medications based on your health history and current medications. Please take them as prescribed. An anti-imflammtory and narcotic pain medication will be prescribed to help control the pain. An antibiotic will be given, and you will be expected to finish the whole prescription of antibiotic.

What Follow-Up Care Will I Receive?

You should have a scheduled follow-up appointment, which usually occurs 1 week following surgery. Typically, the sutures will be removed at this appointment.

You may also call at any time during your recovery if you have any questions or concerns.

When Should I Call My Doctor?

  • If you have difficulty breathing.
  • If you have increased swelling 2-3 days after surgery.
  • If you have difficulty closing your eyes after surgery.
  • If you are unable to urinate.
  • If you have severe pain that is not relieved by medications.
  • If you experience a rash, nausea, vomiting, severe headache, severe constipation, or other unexpected reactions.
  • If you have an oral temperature over 100.5 degrees.
  • If you have a question or concern that must be addressed prior to the follow-up visit.

Who Should I Call If I Have Questions?

Dallas Surgical Arts Phone Number 972-566-4900, Monday – Friday during business hours. After business hours, the office number will be able to get in contact with the doctor through a call service.