Orthognathic Surgery Post-Operative Instruction Sheet

DIET:

The average orthognathic surgery patient loses five to ten pounds after surgery. This is a reflection, in most instances, of a loss of appetite, but can be controlled with dietary counseling and supplements. We recommend a liquid nutritional vitamin supplement such as Ensure, etc.

By one week following surgery, your appetite should be sufficiently improved to maintain and possibly increase weight. It is important to emphasize that orthognathic surgery is not time to begin a diet because your body needs good nutrition to support proper healing. For the first week after surgery you will be on a strict liquid diet. The second week you may begin soft, blended foods that do not require chewing. You will be asked to continue on a soft food diet for an additional two – four weeks. You will be on a liquid only diet for the first 48 hours then progress to soft foods such as yogurt, creamed soups, etc. Make sure to drink 3 quarts of fluids daily. Your doctor will advise you of your diet on your postoperative visits.

CLEAR LIQUIDS:
It will be important that you drink a sufficient volume of liquids to maintain hydration after surgery. An average adult requires approximately 3 quarts of liquid every twenty-four hours. While this may seem like a large quantity, it can be achieved by constant sipping. As soon as possible, you will be encouraged to drink clear liquids. A large catheter-tipped syringe will be available to assist you in taking fluids. You will also be encouraged to drink from a glass or cup. Remember; drink plenty of fluids to assist in the healing process.

SLEEP:
Sleep with your head elevated at a 45-degree angle (two pillows) for the first two weeks after surgery to help minimize swelling.

NAUSEA AND VOMITING:
You may experience some nausea after surgery. It is important to realize that this is not a life-threatening situation and is usually caused because your stomach is empty or caused from medications. Therefore, if vomiting does occur, remain calm, turn your head to the side, and let the fluid clear your mouth freely. If nausea persists, please call our office.

MINOR BLEEDING:
It is common to experience some degree of minor bleeding following surgery. Minor nosebleeds may be expected for a period of one to two weeks following upper jaw surgery. Drains may be placed during lower jaw surgery that will need to be removed the next day. There is no discomfort during the removal of the drains.

MEDICATIONS:
Following surgery or at your preoperative appointment, you will be given prescriptions for antibiotics and pain medication. It is important to eat before taking any pain medication to avoid possible nausea.

SWELLING:
You can anticipate that swelling will occur, but the degree of swelling is quite variable in each individual. More swelling usually occurs with lower jaw surgery than with upper jaw surgery. Swelling will continue to increase for approximately 24 – 48 hours following surgery and will remain unchanged until approximately one week after surgery. Most patients experience the most swelling on the third day after their procedure. The third day is calculated not using the surgery day itself. During the second and third weeks, swelling will begin to resolve dramatically. Ice packs should be used immediately following surgery for the first 24 – 48 hours for 20 minutes on and 20 minutes off. Applying a moist heat is recommended after the initial 48 hours. Nasal congestion may occur with upper jaw surgery. You may use a saline nasal spray if needed.

POSTOPERATIVE PAIN:
Pain may be anticipated; in most instances, however, it is mild and treated easily with medication. If bone grafts are taken from the hip, more discomfort may be anticipated.

WALKING:
You are encouraged to walk as soon as possible even if bone was taken from the hip. This will decrease swelling, increase appetite and fluid intake and return the sleep/wake cycle to a more normal pattern.

CLEANING THE TEETH:
You will be encouraged to brush your teeth following each meal beginning two days after surgery. Use a child’s soft toothbrush and pay particular attention to keeping the brush in contact with the teeth. In addition to brushing, a mouth rinse should be used. It is suggested that you add hydrogen peroxide, diluted by three to four parts, to the mouth rinse or use Peridex oral rinse if prescribed by your doctor. Do not use a water-irrigating device (such as a Water Pik) for at least two weeks following surgery.

Driving:
You may not drive for two weeks following your procedure.

ADDITIONAL INFORMATION:
There is a terrific web site/chat room for patients undergoing orthognathic surgery. The keyword is:

orthognathicsupportgroup.com

This site was developed by a patient who underwent orthognathic surgery and has patients who are just beginning orthodontic care to those who are several years post-op. There are also some good recipes for soft diets that are delicious.

If you have any questions regarding these instructions, please call our office at (877)523-3223 or Novasurgicare Phone Number 703-288-4495. Please leave your name and phone number and someone will return your call as soon as possible. Please do not use the after hours number for prescription refills as this can only be done during regular business hours.