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Corrective Facial Surgery


Hospitalization

In most cases, patients will be in the hospital 1-3 days following the surgery.

Nausea and Vomiting

Not 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.

Swelling

You 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 Surgery

It 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 Stuffiness

Nasal 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.

Splints

In 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 Together

For 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 Pain

Because 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 Home

You 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 Home

Patients have told us that several items have been helpful during their recovery period. We would like to share these with you:
•  A child’
•  s toothbrush, several may be necessary as they wear quickly
•  The use of a sippy cup or commuter cup for drinking while your jaws are wired together.
•  Lip balm or Vaseline for your lips.
•  A blender
•  A strainer (wire mesh or coffee filter system).


Vocabulary


Asymmetry

Uneven jaw

Bone Graft

Bone removed from one part of the body (usually the hip) and used in another region of the body.

Bone Plates

Small 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 Radiographs

Special X-rays of your skull and facial bones needed before and after surgery.

Intermaxillary fixation

Teeth wired together

Mandible

Lower jaw

Maxilla

Upper Jaw

Occlusion

Bite relationship of your teeth

Orthognathic surgery

Surgery to move the jaws

Osteotomy

Cutting and moving of bones

Paresthesia

Numbness of surgical site (upper and/or lower lips). The numbness may be temporary or permanent

Splint

Small piece of plastic placed between your teeth to position your teeth and jaw bones.

Study Models or Scans

Models 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 hooks

Small hooks or wires placed on your braces by your orthodontist before surgery. These are used for rubber bands and to wire your jaws together.

TMJ

Abbreviation for temporomandibular joint (jaw joint)

Nutrition

Intermaxillary 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.
•  All food must be blended and strained to remove food particles prior to drinking.
•  Try nutritional supplements such as Ensure, Nutriment or instant breakfast drinks (all are available in supermarkets and drug stores)
•  Health food stores carry ready made milkshakes such as Rice Dreams, VitaSoy or AmZake. Also available are protein powders such as Weight Gainer 1850 which are easy to add to milkshakes or juices.
•  Other suggestions for on-the-go meals include canned juices (V-8), fast food restraint milkshakes, baby food and fruit in a jar, as well as yogurt.
•  Try to make double batches and freeze in small containers for later use.
•  If you were taking vitamins before, continue to do so. Whole vitamins can be smashed in a cloth, with a hammer and then dissolved in juice.
•  Clean your mouth properly after each meal.
•  If you have lactose intolerance use a milk substitute such as Mocha Mix, Dairy Rich or nut milk.
•  If diarrhea develops, Try decreasing milk and milk products. Call your surgeon if diarrhea persists.
•  DO NOT USE A STRAW as this could damage the incision or break a wire. Most people prefer to drink liquids from a cup with a lid such as a commuter cup or a tippy cup


RECIPES WHILE YOU ARE STILL IN WIRES or RUBBER BANDS




AFTER YOUR JAW HAS BEEN UNWIRED

It 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 surgery
The 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.

Livermore
1133 E. Stanley Blvd. #215 • Livermore, CA 94550
Phone: 925-290-7727 Fax: 925-294-8800
Tracy
2160 W. Grant Line Road #160 • Tracy, CA 95377
Phone: Phone: 209-835-4600 • Fax: Fax: 209-835-8833

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