Corrective Facial Surgery
HospitalizationIn most cases, patients will be in the hospital 1-3 days following the surgery.
Nausea and VomitingNot uncommonly, you may experience some nausea or vomiting during the postoperative period. If vomiting occurs, it is important to remain calm and call the nurse, so he/she can assist you and then lean you forward. The liquid from your stomach can be pushed through your teeth and suctioned.
Nausea and vomiting are commonly caused by inadequate intake of liquids. It is important to drink liquids very often during the day.
Although wire cutters are available to trained personnel in the hospital, it is unusual to have to cut wires or rubber bands that are holding your jaws in position. The nurses who care for you are experienced in dealing with patients who have their jaws wired together. It is not necessary to send you home with wire cutters. Remember…vomiting is not a life-threatening experience: remember to lean forward and push the liquid out of your mouth with your tongue.
SwellingYou can anticipate swelling will occur and the degree of swelling is quite variable in different individuals. More swelling usually occurs with the lower jaw surgery than with the upper jaw surgery. Swelling will continue to increase for approximately two to three days following surgery and will dramatically resolve within ten days to two weeks. Application of ice-packs to the jaws, for the first three days, will help minimize the swelling. In some cases, some swelling may remain for several months.
Minor Bleeding Following SurgeryIt is common to experience some degree of minor bleeding following surgery. Minor bleeding may be expected for a period of one week following upper jaw surgery.
Nasal StuffinessNasal stuffiness, following maxillary surgery (upper jaw), is common and is to be expected. When this occurs, it can be managed with a combination of nasal sprays and cleansing of the nostrils. It is suggested you remove nasal secretions and scabs using cotton swabs soaked in a solution of hydrogen peroxide and water (one to three parts).
When it is necessary to use Afrin nasal spray, it should be sprayed with enough force for you to taste the medication. When used correctly, this will provide relief in approximately three to five minutes. The nasal stuffiness will resolve within approximately one week following surgery. You are not to blow your nose for at least three weeks following upper jaw surgery.
If nasal stuffiness continues after you arrive home, a humidifier may be used in addition to the above procedures. This is usually not required but may be helpful in special instances.
SplintsIn many cases, a splint is used. A splint is a 3-D printed plastic guide placed into the new bite (occlusal relationship). After the jaws have been divided, the teeth are wired together into the splint to establish and maintain the correct jaw position. The splint is constructed out of clear plastic (acrylic) and is not visible to the casual observer. This will remain in place until the jaws are unwired.
Teeth Cleaning With Jaws Wired TogetherFor wound healing to occur, you must brush your teeth after each meal. A child’s toothbrush should be purchased at your local store before your hospital admission for this purpose. It is important that you brush all the way in the back since the incisions for the lower jaw surgery are in this area and must be kept free of food. You need not worry about damaging the incision with a toothbrush.
You are cautioned not to use a water irrigating device such as a “water pic” until approximately two weeks following surgery. These irrigating devices have enough force that if used immediately following surgery, it could result in ripping open the incisions in your mouth.
Postoperative PainBecause of the numbness from your surgery, postoperative pain is minimal. While in the hospital, you will receive intravenous medication for the pain and will be sent home with a liquid pain medication.
Activity at HomeYou should expect to be fatigued the first two weeks after your surgery. Do not over exert yourself, but it is important that you do light activity such as walking. You should strive to return to your normal routine of activity when possible. Lifting heavy objects (nothing more than 5 lbs.) is forbidden for four weeks. Lifting heavy objects will delay bone healing.
Handy Items to Have at HomePatients have told us that several items have been helpful during their recovery period. We would like to share these with you:
Bone GraftBone removed from one part of the body (usually the hip) and used in another region of the body.
Bone PlatesSmall metal plates and screws used to hold bones in their new position. These are made of titanium which is an insert metal. They usually remain in place all your life and do not require removal. They will not set off the metal detectors in airports.
Cephalometric RadiographsSpecial X-rays of your skull and facial bones needed before and after surgery.
Intermaxillary fixationTeeth wired together
OcclusionBite relationship of your teeth
Orthognathic surgerySurgery to move the jaws
OsteotomyCutting and moving of bones
ParesthesiaNumbness of surgical site (upper and/or lower lips). The numbness may be temporary or permanent
SplintSmall piece of plastic placed between your teeth to position your teeth and jaw bones.
Study Models or ScansModels of your teeth done by your orthodontist. The models determine if you are ready for surgery. They are also needed before surgery to make a template of your actual surgery.
Surgical hooksSmall hooks or wires placed on your braces by your orthodontist before surgery. These are used for rubber bands and to wire your jaws together.
NutritionIntermaxillary fixation (IMF) requires a change in diet that can be difficult at first. Modification of a simple and pleasurable routine, such as eating, can almost overwhelm the person who is not prepared. It is essential that you try to maintain your weight – this is not the time to diet. Men normally require approximately 2600 calories daily and women require approximately 2000. For proper healing, you may need more calories, protein and vitamins than normally. To help meet these requirements eat more frequently (6-8 times a day). The following suggestions will assist you to a healthy and successful recovery.
RECIPES WHILE YOU ARE STILL IN WIRES or RUBBER BANDS
AFTER YOUR JAW HAS BEEN UNWIREDIt is very important that you follow our instructions after your teeth have been unwired. At this time, the jaws are not completely healed and may require re-operating if these instructions are not carefully followed.
After the wires are removed, small rubber bands will be replaced on your teeth to hold the jaws in the proper position. You should wear the rubber bands all the time except when you eat and brush your teeth. The rubber bands should be changed daily so they maintain their stretch.
Your diet after unwiring is very important. Although you can open your mouth and eat, you must stay on a soft diet. You may eat foods that do not require chewing. The following are examples:
Board certified in Oral & Maxillofacial surgeryThe surgical specialty of oral and maxillofacial surgery requires up to six additional years of hospital based surgical and anesthesia training beyond dental school.
Contact Pacific Oral and Facial Surgery Center Today!The first step to a healthier, happier you.
Livermore1133 E. Stanley Blvd. #215 • Livermore, CA 94550
Phone: 925-290-7727 Fax: 925-294-8800
Tracy2160 W. Grant Line Road #160 • Tracy, CA 95377
Phone: Phone: 209-835-4600 • Fax: Fax: 209-835-8833