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Orthognathic Surgery

Date issued: January 2024

Review date: January 2026

Ref: B-369/Maxfax/KD/Orthognathic surgery v3

PDF: Orthognathic handout pre-surgery final January 2024 v3.pdf[pdf] 193KB

You are about to come into hospital for surgery to correct the position of your jaws. This information is to remind you what to expect before, during and after your operation. If you have any concerns, or there is anything that you don’t understand, please talk to your orthodontist or surgeon.  We are happy to answer any questions.

Shortly before the operation

You will be asked to attend for a pre-operative assessment. This appointment is to check your health before your operation.

You will have 2 appointments with your orthodontist to take records of your teeth and to plan your surgery in detail. Small attachments will be added to your brace to help the surgeon during your operation.

The operation

You will normally come into hospital on the morning of your operation. Clear instructions will be sent to you explaining what to bring for your hospital stay and how to prepare for this.  You are likely to be in hospital for 2-3 days.

Your surgery will take place under a general anaesthetic. The operation will be carried out from inside your mouth, so there will be no external scars.

The operation will take several hours to complete, and you will also spend a few hours in the recovery suite before you return to the ward. So please tell your relations not to expect you back on the ward immediately after your operation.

On the evening of your operation, you will feel groggy and tired. One visitor will probably be all that you can cope with.

You may feel nauseous (sick) after the operation or may even vomit. This is usually due to small amounts of blood being swallowed, which irritate the stomach. This feeling will pass.

You may have 2 small temporary drains to allow fluid to drain away from the operation site. These will be used to help reduce swelling if you are having an operation on your lower jaw.  These drains will usually be removed on the second day after surgery.

The first few days after the operation

You will be able to open your mouth almost immediately after the operation because each jaw is fixed using small plates and screws. Very occasionally it may be necessary to use wires to hold the top and bottom jaws together. The likelihood of this happening to you will be discussed before your operation.

You will experience some pain and discomfort, but this does vary from person to person. Immediately after the operation your throat may be uncomfortable, and swallowing can be difficult.  While you are in hospital, we try to control any discomfort with appropriate drugs. You will be discharged from hospital with tablets to help you deal with any further discomfort.  If you need more painkillers than those prescribed, please ask your own doctor for some more.

You will experience some facial swelling and bruising after surgery. This is NORMAL but different patients experience different amounts of swelling and bruising. So don’t worry if your face looks very swollen for the first week after surgery. Swelling is always very noticeable at this time. It will gradually become less, but a small amount of swelling may remain for several months.

You will definitely experience some numbness or tingling near to the operation site immediately after your operation (usually affecting the lips or cheeks). For most people sensation gradually begins to return a few weeks after surgery and as this happens you may experience sensations in your face or teeth which you cannot explain.

You may experience one or more minor nosebleeds after surgery if you have had an operation on your top jaw.

Your lips will feel very dry after the operation and will be sore. We recommend that you use Vaseline™ to moisten your lips for the first few weeks after surgery.

It is very important to keep your mouth and teeth clean after the operation. You will be given an antibacterial mouthwash to use while you are in hospital, and you should start tooth brushing as soon as you can.  We recommend that you use a baby toothbrush for the first few weeks after surgery.

A very soft diet is recommended for the first few days after the operation e.g., soup, yoghurt or porridge.

Please request a pureed diet while you are in hospital. Your orthodontist will give you a menu showing what meals are available on the ward in pureed form. We will also give you advice sheets with recipes for a pureed diet & nourishing drinks.

It is important to start drinking normally as soon as you can. This will help your recovery. You will not be allowed to leave hospital until you are drinking normally.

When you get home

You will need someone to look after you for at least the first few days when you arrive home. You will not feel like doing much yourself. Please arrange to be with a responsible person who is prepared to look after you. If you have young children, you will definitely need someone to take care of them when you first come out of hospital.

Most patients feel a bit depressed for a couple of weeks after the operation, due to discomfort, swelling and tiredness. This feeling will pass.

You should only eat soft food for the first 6 weeks after surgery. Your orthodontist will give you some ideas and recipes for suitable meals. Foods such as scrambled eggs, omelettes, rice, pasta, mince, stews and soups are all good choices. Approximately 6 weeks after your operation you will be able to eat a fairly normal diet, but you will still need to avoid very hard or chewy foods for 3 months after your operation.

Make sure that you continue to keep your mouth and teeth clean. Thorough tooth brushing is important, and you should continue to use an antibacterial mouthwash for the first week after surgery while your mouth heals.

Your stitches will partly dissolve and start to drop out about 1-2 weeks after the operation. Don’t worry about this.

Occasionally patients continue to feel nauseous (sick) when they leave hospital. If you feel like this and you are concerned, please contact us or contact your own doctor. Occasionally people have a reaction to the tablets they take after surgery.

After a few weeks  

You will need to come back to the hospital for outpatient appointments fairly frequently for the first few weeks after surgery, so that we can check your recovery.

Your bite will not be perfect immediately after surgery. In the weeks following surgery your orthodontist will put elastic bands on to your braces to guide your teeth into the best possible positions.

Your brace will stay on your teeth for about 6 months after surgery. It is easy to get impatient at this stage of treatment but keeping the brace on will help you to achieve the best possible result.

You will normally be away from work/college for approximately 3-6 weeks. This varies from patient to patient and depends on the type of operation. Most patients feel quite tired after surgery, and it usually takes a few weeks to get back to normal.

You are advised to avoid all contact sports for at least 3 months after surgery.

Numbness or tingling near to the operation site may last for between 6 weeks and 6 months, but sometimes it can be permanent. A minor degree of persistent numbness or tingling is fairly common, but usually only affects a small area of the face.  Most patients get used to this slight change in sensation and are not worried by it. The movement of the face is not affected.

There is also some very good information about surgery and recovery on the following website:   www.yourjawsurgery.com

In case of problems

If you have any concerns, you can telephone to ask for advice during the day (Monday to Friday, 8.30am to 4.30pm):

Reception:                            01752 432983

If you have serious concerns outside these times, then please telephone:

Lynher Ward:                        01752 792274

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