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Post Operative Instructions – Orthognatic Surgery

Post Operative Instructions – Orthognatic Surgery

If necessary, your surgeon will prescribe medication to relieve pain. Take them as shown on the dosage. Pain or analgesic medication can be used in three categories. Tylenol is an excellent analgesic which does not cause pain. It is usually recommended to take regularly during the first two postoperative days. Anti-inflammatory drugs such as Naprosyn or Ibuprofen (Advil or Motrin) help reduce pain and swelling. These drugs do not normally cause drowsiness. Although, they can cause stomach pain. If this occurs, you can consult your pharmacist because they can provide non-prescription medication to alleviate the pain in the stomach. Alternatively, you can contact your surgeon immediately. Finally, painkiller narcotics such as codeine, oxycodone and hydromorphone are derivatives of morphine and are used to treat greater pain but they cause drowsiness and nausea. If symptoms become too problematic, it is recommended to stop their use. We recommend that you recontact your surgeon if these drugs are causing significant symptoms and pain.

It is normal to feel a numbness in the face after orthognathic surgery. Your surgeon will follow-up on this numbness. However, this will usually make you feel less pain during the postoperative period.

After your jaw surgery, severe swelling of the face follows. During your hospitalization, you receive drugs to prevent excessive swelling. This swelling is completely normal. You should apply ice to the area of ​​surgery for 15 minutes every hour for 48 hours. On the second day, the application of a warm wetted compress promotes faster resolution of swelling. We recommend that you sleep with your head slightly elevated. The swelling usually increases within 24 to 48 hours and then gradually decreases. It can persist for up to 3-6 weeks after surgery.

It is normal to bleed moderately within 24 to 48 hours. If the bleeding is heavy, apply gauze to the wounds in the mouth for about 30 minutes and replace them every 30 minutes until bleeding stops. It is important to avoid rinsing, spitting, or use of a drinking straw for 24 hours after surgery. It is also possible that there are ecchymoses (bruises on the skin). This is normal after a major surgery of the face and the bruises will diminish with time. It is also possible that a nosebleed may occur. In this case, you must lie down, elevate your head and apply gentle pressure to the nose. The bleeding should disappear in the next half hour. If the bleeding is very heavy or does not stop, we recommend that you contact your surgeon or go directly to the emergency room of the hospital where you had your surgery. For uncontrolled bleeding, contact the surgeon on call. It is very important to avoid blowing your nose for a period of at least two weeks after your surgery. If you feel congested, use a nasal spray such as Salinex. If you blow your nose, a major nose bleed and facial swelling may occur due to the introduction of air under the skin.

Antibiotics and Infection
An antibiotic may have been prescribed to treat or prevent infection. If this is the case, follow the directions on the container. You should continue the medication if you have no swelling or pain. Infections are relatively rare and occur on average three to five days after surgery. Here are the symptoms that may indicate an infection: swelling, firm and painful cheek, difficulty of opening the mouth, bad taste in the mouth, the presence of white yellow pus or difficulty swallowing.

During the two weeks following your surgery, no chewing is permitted between the teeth. Everything must be liquid or pureed. You can use the syringe that has been provided to facilitate your diet. It is very important to have a sufficiently high protein intake. We recommend that you get protein supplements such as Ensure or Boost. Thereafter, a gradual change in diet can be made, or the introduction of foods that are easy to chew (pasta, omelette, fish or hamburger). Usually six weeks after your surgery, it is possible to chew normally.

Oral Hygiene
It is important to keep your mouth clean. It is possible that you have a prescription for antibiotic mouthwash. This mouthwash should be used as directed. You can also rinse your mouth with saline solution by mixing one teaspoon of salt in a large glass of warm water. You can wash your mouth up to four times per day. It is especially recommended to do so after meals. Do not start rinsing your mouth before 24 hours after the surgery to prevent bleeding. It is recommended to brush your teeth three to four days after surgery. Oral hygiene reduces the chances of getting an infection.

It is possible that you have nausea and vomiting after the surgery and medication intake. It is recommended to first stop taking painkillers such as codeine, hydromorphone or oxycodone narcotics. You can continue taking Tylenol and anti-inflammatories as needed. If you do not have allergies, you can take Gravol. We recommend you get some at the pharmacy and follow the recommendations of the pharmacist. If nausea occurs, wait 45 minutes and try to eat a small amount of food at a time.