Orthognathic (Jaw) Surgery

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After Your Surgery

Post-Operative Instructions
Hospital stay

The hospital will contact you at least 48 hours prior to let you know exactly what time and where you should report. You will be asked to arrive a few hours before your scheduled surgery. The length of your actual surgery is approximately 2–3 hours per jaw.

Immediately post-op

You will likely recover from the anesthesia in the Post Anesthesia Care Unit (PACU) for an hour or so. You will then be transferred to a room for further recovery.

During your care in the Recovery Room

A hospital nurse will monitor and assist you. You will be provided medications for pain, congestion and nausea as needed. You will receive antibiotics and steroids at scheduled intervals. You should be able to open your mouth, but you will have some light guiding rubber bands in place. You may have an acrylic bite splint wired to your upper teeth. You will have an ice pack wrapped around your face. You will have an IV in your hand or arm providing you with fluids and medications. You might have a nasogastric tube (through your nose and into your stomach) to reduce the chances of nausea. These tubes are usually taken out early the next morning for overnight stays.

While in your hospital room

A hospital nurse will care for you as directed by Dr. Bryan or Dr. Goodson. Intravenous fluids and medications for pain, congestion, and nausea will be provided as needed. You will be encouraged to start drinking liquids. You will be instructed on oral hygiene, oral and/or facial wound care, and breathing exercises to assist in your recovery from general anesthesia. You may be instructed to walk around (ambulate) to assist your recovery.

First 24 Hours

Medications

Take your medications as instructed. You will be receiving an antibiotic to reduce your chances of infection. A steroid may be given to reduce inflammation and swelling. Ibuprofen or a similar NSAID will reduce discomfort and inflammation. Norco® (hydrocodone with Tylenol®) or a similar narcotic analgesic will reduce pain and discomfort. Sudafed® or a similar decongestant will help you breathe through your nose easier. Saline nasal spray will keep your nasal passages moist. Chlorhexidine gluconate or a similar disinfectant mouth rinse will help keep your mouth clean and reduce the chances of infection. Most patients prefer liquid medications. You may request pill form.

To Help Reduce Swelling

Keep with your head elevated above the level of your heart. Apply ice to your face for at least 30 minutes out of the hour. Expect a good amount of swelling despite our best efforts.

Keep any dressings around the face intact until Dr. Bryan or Dr. Goodson sees you the next morning. Your steroid, NSAID, and pain medications will all help to decrease swelling.

Diet

  • Take in as much fluid as is tolerable while awake to prevent dehydration. A full glass of water (8 oz) every 3 hours if an IV is not running (= 64 oz/day = ½ gallon/day = 2 liters/day).
  • You will be placed on a clear liquid diet (water, light juice, broth, etc.) to start.
  • You should use the restroom as needed. The nurse may be available to assist you.

Expect

  • Minor bleeding and oozing from the surgery wounds and nostrils for the first 24–48 hours.
  • A mild sore throat from the breathing tube.
  • Numbness of your lower lip, chin, cheeks, tongue, and teeth (for lower jaw surgery) and your upper lip, cheeks, nose, and teeth (for upper jaw surgery).
  • Nasal congestion from upper jaw surgery and the breathing tube.
  • Limited jaw mobility due to the surgery.

Oral Hygiene

  • Use a baby tooth brush to keep your teeth clean. Be careful around the incision sites, which will be in the upper vestibule of the mouth (for upper jaw surgery) or in the cheeks near the molar teeth along the back sides of the lower jaw (for lower jaw surgery).
  • Rinse with chlorhexidine gluconate solution twice a day and brush your teeth at the same time. You may wish to brush your tongue during your hygiene periods.
  • Rinse with warm salt water (one teaspoon per 6–8 ounces) every hour or so. Wounds heal faster when they are clean and moist.
  • Depending on the type of surgery, you may have a plastic splint wired to your upper teeth to help you guide your bite into the right location. Keep this area clean also.
  • Depending on your specific surgery, you may be asked to use elastic (rubber bands) around your braces to help guide your teeth/jaw into the right bite.
  • For upper jaw surgery: Do not blow your nose nor sneeze through your nose for the first 2–3 weeks. Take any additional antibiotics/medications (nasal decongestants, nasal sprays) as directed by Dr. Bryan or Dr. Goodson.

Upon Discharge From the Hospital

You should have prescriptions and instructions for

  • Strong pain medicine (a narcotic analgesic)
  • Antibiotic
  • Anti-nausea medicine (if it was necessary)
  • Chlorhexidine gluconate mouth rinse (an antibacterial mouth rinse)
  • Instructions to follow up in the office in one week after discharge

You will have Dr. Bryan’s or Dr. Goodson’s cell phone number. They are available 24/7 if you have any concerns.

Questions?
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Please contact our office if you have any questions or issues with these instructions.

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