Orthognathic Surgery Post Operative Instructions

You are now at home. We will reinforce the instructions given to you at the pre surgical appointment.

• Your mouth has a number of rubber bands holding your mouth closed. You can attempt to open to facilitate the passage of fluids or blended diet. If the rubber bands break, they will be replaced when you go back to the office for a post operative appointment.
• Oral hygiene is important and you should brush the reachable teeth at least twice a day. Manual or electric toothbrushes can be used.
• Congestion is normal especially if you had upper jaw surgery. Use normal saline drops obtained at the pharmacy, placing 2-3 drops in each nostril several times a day. An over the counter decongestant can also be taken in liquid form to improve the congestion.
• Sinus precautions for sinus lifts:
  • Take antibiotics until finished.
  • take over the counter decongestant such as Sudafed for the next 5-10 days as instructed in your pre-surgical visit.
  • No smoking, drinking through a straw or blowing nose for the next 4 weeks.
  • If you have to sneeze, open your mouth to sneeze. If not, you will create negative pressure in your sinus, creating the possibility of bleeding and disturbing the sinus graft.
• Sinus precautions:
  • Take antibiotics until finished.
  • take over the counter decongestant such as Sudafed for the next 5-10 days as instructed in your pre-surgical visit.
  • No smoking, drinking through a straw or blowing nose for the next 4 weeks.
  • If you have to sneeze, open your mouth to sneeze. If not, you will create negative pressure in your sinus, creating the possibility of bleeding.
• Diet should be plenty of liquids and blended diet. Milk shakes, smoothies, juices and blended food, following the recipes from the Diet Through a Straw booklet given at the pre-surgical appointment are very helpful in maintaining nutrition and avoiding weight loss during the recovery phase.
• Sutures or stitches will be found in the mouth and skin. They are reabsorbable stitches and should fall out on their own starting the second day after surgery.
• For the first 48 hours after surgery apply cold compresses to face. Afterwards, you can start applications of heat via a heat pad or by placing a moist towel in the microwave for 45 to 60 seconds. Apply to the face until cold and then repeat the process for 48 hours while awake.
• While sleeping, place your head elevated 30 degrees relative to the ground to decrease swelling.
• Swelling will increase up to 4 days after surgery. It will then start to subside slowly over time, up to two months.
• Ambulation: although you just had surgery, we recommend you do not stay in bed while awake to minimize the chances of thrombolytic events leading to stroke, heart attack or pulmonary emboli. Try to transfer to a chair instead of lying down and walk throughout the house. Try to be as active as possible.
• Pain control: NSAID's should be taken first. Any form of liquid ibuprofen as directed can be taken to keep the pain under control. If necessary, you would obtain additional relief by taking narcotic medication as instructed. You should have a prescription for pain relief given to you at the pre-surgical appointment at our office. Most of the times a refill is given.
• Bleeding: if bleeding occurs, it will most likely come from the nasal area. Bleeding from the mouth is also possible. Mild sporadic bleeding can occur up to 3 days after surgery. If bleeding is profuse, please call the office.
• In some instances you will be given a portable suction at the hospital to bring home and help you control your mouth secretions. You can expect decreased sensation of the lower lip and chin and profuse swelling making it difficult to close your lips which can cause drooling. Use it as needed throughout the day, but remember to continue to hydrate since you have to replenish this fluid loss.
• Head wrap: you will have a head wrap when you get home. Use it as long as possible in the next 48-72 hours following surgery. The head wrap can be removed to take showers and reapplied. Make sure the wrap is not excessively tight around your throat. There is no benefit in using it for more than 72 hours.
• Please make an appointment with our office for follow-up 7 to 10 days after the surgery date.
• If any questions or concerns, please call any of the office telephone numbers listed in your paperwork.