Orthognathic Surgery: Post-Surgical Instructions

Please follow the guidelines below. Call your doctor if you notice any unusual symptoms. You are under the influence of medication following surgery; therefore, do not drive, drink alcoholic beverages, sign legal documents or make any major decisions during the next 24 hours. If you have any questions or concerns, call our office at 403-271-1665. There is always a doctor on call after hours.

Swelling and Bleeding

  • Significant swelling is expected. This will peak at 48 hours. Swelling is present for at least 2-3 weeks and up to 3-4 months following surgery. Residual swelling can take up to 1 year to completely subside.
  • Sleep with your head elevated on 2-3 pillows for at least one week.
  • Bleeding can persist on and off for 2-4 days after surgery. Sit upright and apply ice and pressure as tolerated.
  • Bruising can be profound and extend onto the neck and chest. This may last for 1-2 weeks.
  • Profuse nosebleeds that do not slow down with pressure are an emergency. Call 911 first and then our office. These may occur days or even weeks following upper jaw surgery.

Pain

  • Use ice 20 minutes ON and 20 minutes OFF for the first 48 hours after surgery. Ice can also be used for up to 5 days following surgery to help with discomfort. After 4-5 days, switch to moist heat.
  • Take all pain medications as prescribed; Alternate the anti-inflammatory (eg. ibuprofen, naproxen) with the Tylenol-based medication (eg. Tylenol 3, Tramacet) every 3 hours (ie. start with ibuprofen → 3 hours later → Tylenol product → 3 hours later → ibuprofen → 3 etc.).

Diet

  • Stay on a liquid or non-chew pureed diet until you are instructed otherwise by your surgeon. You will be on a no chew diet for at least 6 weeks. Do not use a straw for one month following surgery.
  • Nausea may occur for the first few days after surgery. Drinking clear fluids (eg. water or ginger-ale) can help ease nausea. Taking medications with food (ie. pureed diet) will help prevent it as well.
  • If nausea persists, avoid any narcotic medications. Try to use ibuprofen and plain Tylenol for management of any discomfort.

Oral Hygiene

  • Use the prescribed mouth rinse 3-4 times daily (after eating and before bedtime). Rinse for 1 minute then spit; do not swallow. Rinse several times a day with salt water as well.
  • The day following surgery, you can gently brush your teeth (using a baby or child extra soft toothbrush) in and around your braces (if present). Do not brush your gums.
  • Start changing your elastics 48 hours after surgery (take a photo to remind yourself of placement). Fresh elastics should be used every 1-2 days.
  • Dissolving stitches are commonly used. These may dissolve in 10-14 days OR may last for up to 4-6 weeks depending on the type of suture used.

Restrictions and Activity

  • Early mobilization and walking assist with recovery. Sit upright in a chair to help with swelling and breathing.
  • Do not lift more than 15 pounds for at least 6 weeks. No heavy lifting or vigorous exercise for 6 weeks.
  • Avoid all contact sports or activities that put you at risk for getting hit in the face for at least 2-3 months.
  • If you have had upper jaw surgery performed, do not blow your nose for one month following surgery.
  • Do not smoke cigarettes, e-cigarettes or marijuana after surgery as this affects healing.
  • If you have had a Surgically-Assisted Rapid Palatal Expansion, you will be shown how to turn your appliance at your 1-week follow-up appointment. Schedule regular follow-up appointments with your orthodontist (starting the week after surgery) so they can monitor the expansion.