Post-Operative Instructions: Orthognathic Surgery

1. Go to your nearest emergency room if you are having trouble breathing.
2. Normally, the facial swelling will increase for the first 48–72 hours. Apply ice packs (20 minutes on/20 minutes off) and keep your head elevated (extra pillow or recliner). Most of the swelling will resolve within the first few weeks; however, healing will continue for 4–6 months.
3. Bruising may occur after a few days. In some cases, the bruising may extend onto your upper chest.
4. You may shower, but try to keep the bandages dry. A small band-aid may be applied if they come off.
5. No smoking, as this hinders wound healing.
6. Avoid alcoholic beverages.
7. Brush the teeth gently with a child-size soft bristle brush. You may use toothpaste. Your gums will have reduced sensation. Be careful not to injure the gums while brushing.
8. You may use alcohol-free mouth rinse.
9. If you are given an antibiotic, it should be taken as directed. The first dose may be taken when you arrive at home.
10. The pain medications can be taken as directed on the instructions.
11. Do not lie in bed all day. This can lead to pneumonia and blood clots. Light activity is acceptable, even good. Try to be out of bed during the daytime.
12. You should not drive if you are taking pain medications.
13. Please notify your doctor if you feel that your bite has shifted.
14. Have the wire cutters or scissors with you at all times while the jaws are shut. You may need them in case of emergency in order to open the mouth.

In addition to the above, for upper jaw surgery patients:

Nasal congestion and minor nosebleeds are expected. You may sniff back or wipe the nose, but do not blow. You may use saline nasal spray to loosen clots and mucus. Afrin^® nasal spray may be used for severe congestion, but for no more than 2 consecutive days.

We understand that the first week after surgery can be difficult. Although the swelling peaks 2–3 days after surgery, it doesn’t really start to come down until after the first week. At 2 weeks after surgery, usually 70% of the swelling has resolved. For the final swelling and numbness to resolve, it will take weeks to months after surgery. It is not unusual to be more swollen or numb on one side versus the other.

You will need to be seen 12 weeks after surgery and then every 3 months until your braces are off. After your braces come off, you will need to come into the office for final records.