There are several aspects of your postoperative care which will require special attention. These areas of concern are listed below in the sequence with which you will have to manage them after your surgery.
It is difficult to predict what you will remember immediately following surgery. You may remember waking up in the recovery room or you may not recall this event and only remember waking up in your room.
Remember- your jaws will be held together with elastic or wires. In the unlikely event vomiting occurs, it is most important to position yourself properly rather than take the elastics off. If you are sick, position yourself over a basin or toilet bowl and let the fluids pass between the spaces in your teeth and out your nose. You will not choke. You will need to have wire cutters or scissors at home with you although you will most likely not need to use them. If you feel the need to cut the elastics or wires, cut them out then give us a call so that we can arrange to replace them.
Warm packs to the face after the first 48 hours will help increase blood supply and reduce swelling, speeding the resolution of discoloration associated with bruising. If bruising occurs it will be evident 4-5 days after surgery.
Nasal swelling and stuffiness can also be a problem after upper jaw surgery. This will tend to be worse 48 hours after surgery and will then begin to decrease. The use of Afrin nasal spray or equivalent can be used 2-3 time per day for the first few days after surgery. Use only as necessary. Saline nasal spray, e.g., Ocean Mist, can be used as often as you want. Cleaning of the nose with Q-tips and hydrogen peroxide may be helpful if you have dried, crusted secretions in your nostrils. If you have had upper jaw surgery, DO NOT blow your nose for the first two weeks after surgery.
Pain medication will also be given after your surgery. In the hospital, following your surgery, the pain medication may be administered through intravenous methods. We always encourage you to use oral pain medication as soon as possible as this will expedite your discharge from the hospital and allow for a smoother transition.
Upon your discharge from the hospital, your pain medication will be in pill or liquid form. In general, there is less pain than most would anticipate with this surgery. Due to the dysfunction of the sensory nerve in the areas of the trauma, this may minimize your ability to feel discomfort. Both the oral pain medication and antibiotics will be taken orally. Check with your physician, concerning any medications that you normally take. There may be liquid alternatives, or you may be able to crush and dissolve your normal medications.
REMEMBER: The importance of cleaning your teeth and mouth cannot be over emphasized. This must be done several times each day to keep the mouth and incision sites clean. This will help the wounds heal quickly without getting an infection.
For a period of time following surgery it is likely that your jaw will be held together with either elastics or wires. This allows the bones to heal while they are being held still. Do not attempt to force your teeth apart to eat during this time. In some cases, we use bone plates and screws to hold the bones still to assist in healing. Support may also be given by the splint and elastic traction. This allows early movement and function of the jaws during the early healing period. You may be instructed on the use of “training” elastics after surgery. It must be remembered, however, that the bones are not completely healed and are being stabilized only by the screws and plates. After your teeth have been released from tight fixation, it will be easier to take adequate nourishment but you should not attempt to chew foods until your jaws are healed (for a minimum of 6 weeks after surgery). Anything that you can eat without chewing is encouraged. Attempting to chew too early could cause the bony segments to move and not heal properly, and could require additional treatment. We encourage a gradual progression of movement and use of the jaws, keeping in mind that adequate healing does not take place until approximately 8-12 weeks.
REMEMBER: IT TAKES 6-8 WEEKS FOR INITIAL HEALING OF YOUR JAW OR JAWS AND 4-6 MONTHS FOR A FULL BODY HEALING. If the jaw is hit or bumped early after your surgery, this may cause some shifting in the jaw and bite, SO BE CAREFUL!
X-rays will be required after your surgery. These will be typically done within the first few days after your surgery, then at three months, six months, and one year.
We hope that these postoperative instructions have been helpful for you. We encourage all patients to read these instructions at least once prior to surgery and keep them on hand for reference during the first several weeks after their surgical procedure. We would also encourage family and friends who are involved in your care to read these instructions as this will help them make educated decisions regarding your care. Please contact us at any time with questions.