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.


  • 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.).


  • 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.