After Jaw Surgery
- Most jaw surgeries are performed in the convenience of our office surgical facility. Typically, you will be asked to arrive one hour before your scheduled surgery time.
- We will have you change into a hospital type gown with tight stockings to minimize the chance of blood clots in your legs.
- After your surgery, you will be allowed to recover in our office most of the day, and at that point, you will either be discharged to go home or prior arrangements will have been made to transport you to the Conway Regional Medical Center. Most patients that are transported to the hospital will only need to stay one night; however, each case is handled on an individual basis.
- If you live out of town, we may have you come by our office after you are discharged from the hospital so that we can review final instructions and get a post-operative X-ray.
- There will also be a dressing around your head and jaw area that has a cooling pad inserted within the head wrap. There is an ice chest connected to this cooling pad that must be plugged in at all times and must have fresh ice maintained so that the cooling pad is working properly. It is important to make sure the cooling pad is working properly so that swelling can be kept to a minimum. We will instruct you on how to do this. The head wrap and dressing will typically be removed the day after surgery; however, in some cases, the dressing will be left in place for 2 days. The ice chest is property of our office, so we ask that you please return this after your recovery time frame.
- We find that our level of experience at dealing with jaw surgery patients provides a better situation for our patients in an office setting versus in the hospital recovery room. You will spend most of the day in our office waking up and recovering after surgery.
- You will be given IV medications the day of surgery, and your pain will be managed up until the time of discharge. If you are transported to the hospital, you will typically be on a pain pump that will allow you to manage the pain at your own pace. If you are discharged to go home, you will need to take pain medicine by mouth, which typically comes in the form of a liquid.
- You will also have an antibiotic to take for about one week.
- If you have upper jaw or nasal surgery, we will typically prescribe a decongestant nasal spray as well as a saltwater nasal spray. It is important not to blow your nose for approximately 2 weeks if you have had upper jaw or nasal surgery. Judicious use of the saline nasal spray is recommended. This will be reviewed with you before and after surgery.
- We may ask that you take a steroid dose pack after surgery; however, this is less likely if you are hospitalized because more time will be allowed for us to give steroids through the IV route.
- We require our patients to take probiotics while taking antibiotics to minimize some of the complications associated with antibiotics.
- You will likely be given a prescription for an anti-nausea medication. Please remember that adequate hydration is a very important factor in minimizing nausea for the first several days of recovery. Pain medicine can also make some patients nauseated, so it is best taken with something in your stomach to minimize this risk. It can also cause itching, but typically this will not be in the form of an allergy but as a side effect of the medication. If you experience itching without the development of a rash, then you may want to decrease the dose of pain medicine and consider taking some Benadryl.
- Nutrition is a very important part of your recovery from jaw surgery. We ask that you maintain a no-chew diet for approximately 6 weeks.
- We will provide you with a copy of “Dinner Through a Straw,” which will provide you with nutritional recipe ideas for after surgery. Soups, puddings, broths, and shakes can be consumed for the first few days after surgery. After a couple of weeks, you may find it possible to consume mashed potatoes, scrambled eggs, etc. Ensure Plus, Carnation Instant Breakfast, and products high in protein are very important to maintaining your nutritional status. Dr. Collins will let you know when you can advance to a normal diet.
- It is possible that you may lose several pounds after surgery (10–15 pounds); however, eating frequently, taking in plenty of protein supplements and increasing calorie intake can minimize weight loss and improve your ability to recover quicker. We recommend experimenting with shakes and nutritional protein supplement intake before surgery. Patients that know what they like and can put together high-calorie/high-protein shakes tend to do better than people who experiment post-operatively.
CARE OF YOUR MOUTH
- Typically, we will clean your mouth when you come in for your follow-up, usually 1–2 days after surgery. After this initial cleaning, it is mostly your responsibility to keep your mouth clean.
- It is important to get a soft child’s toothbrush and begin brushing the outside of your teeth as soon as feasibly possible. We will give you instructions on how to do this. Brushing the inside of your teeth may be more difficult until you are a little further out from surgery.
- It is important to start doing warm saltwater rinses as often as possible after surgery. We recommend doing this at least 3 times per day as soon as you can. This should consist of 1 teaspoon of salt in 8 ounces of warm water.
- We advise avoiding harsh mouthwashes such as Listerine; however, dilution of Listerine and/or Scope can be used after a week or two of recovery.
- You may have rubber bands on your braces after surgery, and we will instruct you regarding these.
- In rare cases, your teeth may be wired together after surgery. If this is the case, you will need to always carry your wire cutters with you in case of an emergency. We will give you wire cutters to use after surgery if this is anticipated. After a week or two, it may be possible for you to remove your rubber bands on your own and brush your teeth and then reapply the rubber bands afterward. We will instruct you on how to do this if this is the case.
Swelling can be minimized by keeping the cooling pad in place for 1–2 days after surgery. Swelling usually peaks on or about day 3 or 4. The swelling can be fairly dramatic after some jaw surgeries. We recommend that you keep your head elevated (on 2–3 pillows or in a recliner) for up to a week or so after surgery. Swelling may take several weeks to resolve completely. The majority of swelling will go away in the first week or two after surgery, but a small amount will remain and may take several weeks or months to slowly go away and totally resolve. During the first few weeks after surgery, it is common to be more swollen in the morning, especially if you are not sleeping elevated and end up sleeping on one side or on your stomach. If this persists during the latter part of the day with increased pain, this could be a sign of infection, and you would need to contact our office.
You may need to take at least 2–3 weeks off work/school for your surgery. Most patients feel fairly good after about 2 weeks of recovery, but because of the dietary changes, it may be as long as 6 weeks before you have most of your energy back. Strenuous exercise should be avoided until you have all of your strength back. Since a normal diet is not typically resumed until about 6 weeks after surgery, we advise caution in doing too much strenuous activity until you are back consuming a normal diet and have normal energy reserve. Certain contact sports, which could result in trauma to the face, such as football, basketball, etc., should be avoided for 3 months. Non-contact versions of these sports can begin at 4–6 weeks post-surgery, but trauma to the jaw must be avoided. Patients that participate in the band and use their mouth to play certain instruments may have to avoid practicing for up to 6 weeks. Most patients can return to part-time work after 2 weeks of recovery, but this depends on the individual. We would advise not working or driving a vehicle while you are taking pain medicine.
OFFICE VISITS AND LONG-TERM FOLLOW-UP
You may have anywhere from 4–6 office visits after your surgery. Typically, you are seen fairly early after the surgery for review of instructions, assistance with oral hygiene and obtain X-rays to verify that everything is in the proper position. We may take X-rays during your recovery phase to verify that everything is healing well. We will have you return to see your orthodontist to begin completion of your orthodontic care anywhere from 4–6 weeks after surgery. We may ask you to make this appointment with your orthodontist soon after your surgery so that proper planning and time can be allowed for this appointment. Occasionally, patients will have arch bars placed by us instead of braces, and these are typically removed under IV sedation in the office 4–6 weeks following surgery.
We request that you come in for a final evaluation appointment after you have completed your orthodontic care. This appointment can range anywhere from 6 months to 2 years after your surgery. It will consist of a final set of X-rays, photographs, and exam verifying that you have healed properly and have obtained a satisfactory result. This appointment is very important, and we ask that you please plan this into your post-operative visits.
The following post-operative conditions may occur in jaw surgery patients while healing and progressing normally:
- SWELLING that may reappear several days after surgery (especially early in the morning).
- NUMBNESS of face/lips. This may persist for several months and may take up to one year to resolve. Rarely, patients may have small areas of numbness that do not resolve. If you have significant numbness at 2–3 months after surgery that does not appear to be improving, please notify our office.
- SORE THROAT, which will typically occur for 1–3 days after surgery. This soreness in your throat is typically from the breathing tube and is best managed by pain medication and drinking plenty of fluids.
- BRUISING can occur and will often last for several weeks. Bruising is not as typical with jaw surgery as it is with other skin-type surgeries. However, if you have bruising, it may drop down and be on the upper part of your chest before it finally goes away.
- BLEEDING: Nasal bleeding can occur after upper jaw surgery. It should be treated with Afrin Nasal Spray, elevation of your head, and pressure to that side of your nose/face. Persistent bleeding should be reported.
- TENDERNESS around the IV site. If this should occur, elevate your arm (on pillows) and apply warm moist heat. If the tenderness and swelling of the IV site persist after a few days, please notify our office.
- PERSISTENT BURNING UPON URINATION can be signs of a bladder infection and should be reported. This is a possible complication of having a Foley catheter placed. However, it is very rare.
- SWELLING AND/OR TENDERNESS IN ONE LEG should be reported. One risk of surgery is blood clots that can develop in the leg. We encourage you to get up and walk around during the first few days following surgery to minimize this risk. The stockings that we place on your legs during surgery minimize this risk; however, this can be a serious complication. Tenderness in a calf or swelling in your leg should be reported.
- NORMAL JAW FUNCTION: It may be several weeks before you develop normal jaw function again. It is not uncommon for some patients to not be able to eat normally for about 8 weeks. We ask that you maintain a no-chew diet for 6 weeks, but it may take longer than that to be able to eat normally. Difficulty opening your jaw can occur for several weeks but should be back to normal by about 8 weeks after surgery. If you notice pain in your jaw joint (in front of your ear) and/or a new popping or clicking in the jaw joint, please let us know. Restricted opening that lasts longer than 2 months should also be reported to our office.
- DRYNESS, CRUSTING OF THE LIPS: This is typical for the first week or so after surgery. A&D Ointment seems to work out best for this condition.
- FOLLOW-UP APPOINTMENTS: Please attend all of these appointments because they are very important to your recovery. If you have any questions after your surgery, please feel free to contact our office during clinic hours at Conway Office Phone Number (501) 336-8888. If you have questions or concerns during non-clinic hours, you may text or call Dr. Collins on his cell phone at (501) 730-5180. Emailing Dr. Collins is also acceptable at [email protected]