Orthognathic Surgery: Post-Operative Care Instructions
Proper post-operative care is essential to promote healing, reduce complications, and ensure the best possible outcome after surgery. Please read the following instructions carefully and follow them closely.
General Instructions
Do not drive or operate hazardous machinery for 24 hours after surgery or while taking narcotic pain medications. Avoid alcohol, including cough syrups that contain alcohol, and do not smoke during the recovery period, as these can interfere with healing.
Take your temperature twice daily for the next 7 days and record any fevers.
When to Contact the Office
Please call our office if you experience:
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Nausea or vomiting
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Inadequate pain control with your current medications
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Diarrhea or constipation
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Persistent or increasing bleeding
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Worsening swelling after the fourth post-operative day
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Excessive swelling or redness around the surgical site
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Foul-smelling discharge from the surgical area
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Inability to urinate within 8 hours of discharge
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Fever of 100.4°F (38°C) or higher
Emergency Symptoms — Call 911 or Go to the Nearest Emergency Room
Seek immediate medical attention if you develop:
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Sudden weakness or numbness on one side of the body
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Drooping of one side of the face
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Difficulty speaking or understanding speech
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Sudden loss of vision
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Severe, unexplained headache
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Chest pain
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Shortness of breath
Antibiotics
If you were prescribed antibiotics, take them exactly as directed until the entire course is completed. If you develop a rash, itching, diarrhea, or any other adverse reaction, stop taking the medication and contact our office immediately.
Pain Medication
Take pain medication with food or a light snack to reduce stomach upset. Do not take both liquid and capsule forms of the same medication at the same time, and avoid doubling medications that contain acetaminophen (Tylenol).
For optimal pain control, alternate ibuprofen and acetaminophen every 3–4 hours, unless otherwise instructed. Narcotic medications should only be used if this regimen does not adequately control pain.
If prescribed narcotic pain medication, do not drink alcohol or operate heavy machinery. Narcotics may cause constipation, nausea, drowsiness, or vomiting. Over-the-counter stool softeners such as Colace may help with constipation. If nausea or vomiting occurs, stop the narcotic and call the office. Adjustments can be made to your medication if needed.
Restart all home medications upon returning home unless otherwise instructed.
Sinus Precautions (If Applicable)
For the next 4–6 weeks, avoid actions that increase sinus pressure. Do not forcefully blow your nose, strain, or engage in strenuous activity. Try not to sneeze; if you must, sneeze with your mouth open. Avoid plugging your nose to “pop” your ears.
Decongestants
If congestion occurs, over-the-counter decongestants such as Sudafed may be used unless contraindicated. If prescribed Sudafed or Afrin, take as directed. Saline nasal sprays, humidified air, or Ocean Mist can help relieve nasal dryness. Do not blow your nose until your surgeon allows.
Swelling and Discomfort
Swelling is normal and usually peaks around day three, then gradually improves. Ice packs applied to the face for the first 48 hours (20 minutes on, 20 minutes off while awake) help reduce swelling. After 48 hours, warm compresses may be used as tolerated.
Swelling typically improves by:
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~50% at 7 days
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~80% at 14 days
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~90% at one month
Residual swelling may take several months to fully resolve. Sleeping with your head elevated may improve comfort.
Discomfort, throat soreness when swallowing, jaw stiffness, and facial tightness are common and should gradually improve. Do not force your mouth open unless instructed.
Diet and Hydration
Your diet will begin with full liquids, including smoothies, milkshakes, and thick soups. Nutritional supplements such as Ensure or Carnation Instant Breakfast are encouraged. Aim for 1,500–2,500 calories per day and at least 2,000 mL (two quarts) of water daily to avoid dehydration.
Soft foods may be introduced when approved by your surgeon. If your jaws are wired or tightly rubber-banded, your diet must remain liquefied until released. Syringes or cups may be used—do not use straws.
Oral Hygiene
Good oral hygiene is essential. Brush your teeth gently and rinse with the prescribed mouthwash morning and night. Use warm salt-water rinses after meals. Take care around surgical areas.
Activity
Fatigue is common after surgery. Rest, hydration, and nutrition are critical. Avoid overexertion and gradually increase activity as tolerated.
Wound and Dressing Care
For external incisions, keep dressings dry for the first two days. Afterward, apply bacitracin twice daily for 5–7 days to promote healing and minimize scarring. Skin sutures are typically removed 7–10 days after surgery.
Inside the mouth, dissolvable sutures will fall out on their own in 5–10 days. Mild oozing is normal for the first few days.
Bleeding and Rubber Bands
Some blood-tinged saliva or nasal drainage (for upper jaw surgery) is normal early on. Heavy, fresh bleeding is not normal—call the office if this occurs.
Rubber bands may be used to guide your bite. If one breaks, call the office during business hours for instructions.
Numbness and Discoloration
Temporary numbness and skin discoloration are common after surgery and usually improve gradually. Some altered sensation may persist long-term.
Follow-Up Care
Please return for your scheduled 1-week follow-up appointment. Regular follow-up allows us to monitor healing and prevent avoidable complications. If you have concerns at any time, contact our office.
