Orthognathic (Jaw) Surgery

These instructions are designed to help you recover safely and comfortably after jaw surgery. Please follow them closely, and contact us if you have any concerns.

Diet

  • Click HERE for recipe ideas after Jaw Surgery

  • First 6 weeks: Non-chew, soft, high-protein diet.

  • Eat multiple small meals — do not diet or skip meals.

  • Stay hydrated — aim for more than 1 gallon of fluids daily.

Medications

  • Take all medications exactly as prescribed.

  • If a medicine is not helping, call us — do not stop taking it unless we advise you or you have a reaction.

  • Keep a written record of what you take and when.

  • If you’re prescribed antibiotics, finish the full course, even if you feel better.

  • If your medication makes you drowsy, avoid driving or operating heavy machinery.

Care for the Surgical Area

Do

  • Ice packs: Apply for the first 48–72 hours — 15–20 minutes each hour, with a towel between the ice and skin. Do not sleep with ice packs in place.

  • Moist heat: Begin after day 3 if desired.

  • Oral hygiene: Brush gently with a soft toothbrush three times daily. Use warm salt water, a prescription chlorhexidine mouthwash or alcohol-free rinse.

  • Humidifier: Helps ease breathing and dryness.

  • Sleep elevated: Use 3–4 pillows.

  • Shower normally.

  • Shave carefully in numb areas.

Do NOT

  • Do Not blow your nose (especially after upper jaw surgery — minimum 8 weeks).

  • Do Not lift over 20 lbs or do strenuous exercise until cleared.

  • Do Not play contact sports for at least 3 months.

  • Do Not use a Waterpik for 2 weeks (or until cleared).

Rubber Bands & Splints

  • Wear as directed — usually 24/7 except when eating or brushing.

  • Replace daily.

  • Splints may remain up to 6 weeks to maintain jaw alignment.

When to Call Us Immediately

  • Uncontrolled bright red bleeding.

  • Difficulty breathing.

  • Sudden increase in swelling or fever.

  • Allergic reaction to medications.

Expected Recovery Milestones

  • Swelling: Peaks at 2–3 days, improves over 2 weeks.

  • Bruising: May spread to neck/chest before fading.

  • Numbness: Common; may take months to resolve.

  • Sore throat/nasal stuffiness: Common after upper jaw surgery — use saline spray and humidifiers as needed.

Activity

  • Walk daily as tolerated to improve circulation.

  • Avoid heavy lifting for 8–10 weeks.

  • Avoid swimming for 8 weeks.

  • Always wear seatbelts and protect your face from injury.

HOSPITALIZATION
The operating room will call you 24-48 hours before the surgery and tell you what time you need to
arrive the day of surgery. It is very important that you arrive on time. In most cases, patients having
mandibular (lower jaw) surgery will be discharged from the hospital the same day of the surgery.
Patients having maxillary surgery (upper jaw) or both upper and lower jaw surgeries will likely remain
in the hospital until the next day. Families should plan to be here at least by 9am to pick the patient up.

DAY OF SURGERY
You will be seen by the anesthesiologist and/or nurse anesthetist who will be administering your general
anesthetic during the operation and your surgeons will see you before surgery. Prior to surgery a preop
nurse will place an IV, put sequential compression devices on your lower legs to help prevent blood
clots, and have you spray your nose with a decongestant. The nurse may also collect a small amount of
blood for tests and if you are a female of child-bearing age you will be asked to provide a urine
specimen for a pregnancy test. When it is time, you’ll be brought back to the operating room by the
nurse.

You will receive a general anesthetic and be completely asleep during your operation. When you
awaken you will be in the recovery room. Most patients will be in the recovery room approximately 2-4
hours before they are discharged home or sent to their hospital room.

NAUSEA
If you have a history of severe nausea after surgery, please let your surgeon and the anesthesia team
know. Not uncommonly, you may experience some nausea during the postoperative period. Many
patients are concerned about nausea and vomiting, but this should not frighten you since you will have
an empty stomach. If you feel nauseated, ask for medication to relieve those symptoms. If you have rubber bands holding your teeth together and vomiting occurs, it is important to remain calm, lean forward, and allow the fluids to flow
around and through your teeth. You will have suction at bedside to help clear the remaining liquid. Also, call the nurse so they can assist you.

NUMBNESS
After the surgery, you will experience altered sensations or numbness in areas of your lips, cheeks,
tongue, gums, or teeth. While the nerve fibers are healing, you may experience strange sensations or
tingling in these areas. Normal sensations usually return in six months or less. On rare occasions, the
altered sensation may be permanent and we will discuss this with you before and after your operation.

MINOR BLEEDING FOLLOWING SURGERY:
It is very common to have some mild bleeding during the first few hours after your surgery. You will be
shown how to use the small suction apparatus at your bedside to remove any small amount of blood plus excessive saliva which may accumulate in your mouth. The type of bleeding and drooling that might
require suctioning stops within the first 24 hrs. It is not unusual to experience some minor bleeding
from your nose or mouth during the next 7 to 10 days, especially when you bend over.

WALKING AND DEEP BREATHING:  
You will be encouraged to get out of bed and walk around as soon as possible after surgery. You will
also be asked to take frequent deep breaths (like sighs) to help your lungs recover from the anesthetic.
The earlier you are up and about, the more normal you will feel and the less likely to develop other
complications. Make sure there is someone there to assist you when getting out of bed.

SWELLING / BRUISING: 
You can anticipate swelling will occur and the degree of swelling is quite variable in different
individuals. More swelling usually occurs with lower jaw surgery than with upper jaw surgery.
Swelling will continue to increase for approximately two to three days following surgery and will
dramatically resolve within two weeks. Application of ice packs to jaws for the first three days will help
minimize swelling. If you have new swelling after the first week, then please call your Doctor as this is
often an indication of a postoperative infection.

Bruising is also quite variable in different individuals. It often worsens a few days after surgery and then
gradually fades over the first two weeks. Gravity will often cause the bruising to go into the neck and
even the chest.

NASAL STUFFINESS AND SORE THROAT:
Nasal stuffiness, following maxillary surgery (upper jaw), is common and 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 crusting and scabbing using a cotton swab soaked in a solution of peroxide
and water (one to three parts).

You are not to blow your nose for at least eight weeks following upper jaw surgery, or until your
physician gives their okay to do so. If nasal stuffiness continues after you arrive home, a humidifier may
be used in addition to the above procedures. This is not required, but may be helpful in special
instances.

You will likely have a sore throat immediately after the surgery. This is caused by the nasal tube used
for your anesthesia and the manipulation required placing it in the proper position. Humidified oxygen
may be given after surgery by face mask to help keep the nasal passages moist and help soothe the sore
throat. 

SPLINTS: 
In many cases, a splint is used. A plastic splint is constructed from your dental models that have been
placed into the new bite relationship. After the jaws have been divided, the teeth are wired together into
the splint to establish and maintain the correct position. The splint may be wired to your upper teeth to
establish and maintain the correct jaw relationship. It may be necessary to wire your jaws together (into
the splint) to assure proper alignment and healing. The splint will remain in place a maximum of six
weeks. Although it is annoying and collects food debris easily, it plays a vital role in helping your
muscles adjust to the new jaw position.

ORAL HYGIENE:
In order for good wound healing to occur, you must brush your teeth after each meal. A soft child’s
toothbrush should be purchased at your local store before your surgery for this purpose. The choice of
toothpaste is up to you. It is important that you brush all the way in the back since the incisions for lower
jaw surgery are in this area and must be kept free of food. The mouth is naturally full of bacteria and
keeping your teeth and braces shiny is the best thing you can do to aid the healing process. You need not
worry about damaging the incisions with the toothbrush.

You are cautioned not to use water irrigating device such as a Water Pik until approximately two weeks
following surgery or as instructed by your surgeon. These irrigating devices have sufficient force that if
used immediately following surgery, it could result in the breakdown of the incisions in your mouth.

POSTOPERATIVE PAIN:
Most patients are pleasantly surprised at the usually low level of postoperative pain after the surgery.
This is because the great majority of patients have numbness immediately after the surgery. While in the
hospital, you’ll receive IV medications for pain and you will be sent home with appropriate pain
medications.

Medications:
Motrin or Ibuprofen: If you are not allergic to Motrin, you will likely be given a prescription for this drug. You will be given
a concentration of between 600mg and 800mg. Please take this drug as directed for the first five days.
This drug will help reduce the swelling and will help with the pain as well.

Narcotic Medication (Norco, Hycet, Tylenol #3, Percocet): Unless you are allergic to one of these drugs, you will be given a prescription for one of them. You will be given a tablet unless you are wired shut in which case you will be given the liquid form. These drugs are very strong narcotic pain medications. Do not mix them with alcohol or other narcotics or other
drugs without specific permission from your doctor. DO NOT OPERATE MACHINERY OR TAKE CARE OF OTHERS WHILE TAKING THIS MEDICATION. These drugs can make you drowsy or nauseated. TAKE THESE DRUGS AS PRESCRIBED, DO NOT TAKE ANYMORE THAN THAT. TAKE THESE DRUGS AS YOU NEED THEM ONLY!!

Antibiotics:
If you are given an antibiotic, TAKE IT ALL UNTIL IT IS GONE AS PRESCRIBED BY YOUR
DOCTOR. If you are a female on birth control pills, be aware that antibiotics can decrease the
effectiveness of birth control pills. Please use alternative methods of birth control.

ACTIVITY AT HOME:
You should expect to be fatigued the first week after surgery. You have just undergone a major medical
procedure. Do not over exert yourself, but it is important that you do activities such as walking. You
should strive to return to your normal routine of everyday activity when possible. Lifting heavy objects
(nothing more than 20 pounds) is forbidden for 8-10 weeks. Lifting heavy objects can disrupt and delay
bone healing.

Do not:
1. Swim for 8 weeks after surgery.
2. Upper jaw surgery patients cannot blow their nose for 8 weeks. If you have a sudden onset of
facial swelling, please notify your surgeon.
3. Protect your face from injury. Wear lap and shoulder restraints while driving and maintain a safe
distance from airbags. Do not participate in contact sports for 3-4 months.
Items to have at home:

Patients have told us several items that have been helpful during the recovery period. We would like to
share these with you:

1. A child’s toothbrush, several may be necessary as they wear quickly.

2. A sippy cup or commuter cup for drinking if your jaws are wired together.

3. Alcohol free mouthwash. Mouthwashes containing alcohol can burn tissues without you feeling it.

4. Something to keep your lips moist such as Vaseline.

5. A blender. 

NUTRITION:
During the weeks immediately after your surgery, while your bones and soft tissues are healing, your
diet is very important. The diet should be a soft, non-chewing, high protein diet. This is not the time to
go on a diet to lose those couple of extra pounds. Your body needs calories and protein to optimize
bone healing after surgery.

We recommend that you have a blender to puree almost any food you like. If your jaws are rubber-banded
together, you will be limited to a strictly liquid/puree diet which you may take by using a syringe with a
rubber tube (provided to you if necessary) or you may choose to use a straw to drink from a cup.
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 – once again this is not the time to
diet. Men normally require approximately 2600 calories daily and women require approximately 2000.

For proper healing, you need more calories, proteins and vitamins than normally. To help meet these
requirements, you must eat more frequently up to six-eight times a day. The diet guide will assist you to
a healthy and successful recovery. We recommend reviewing the list of recipes you are given and finding the foods that appeal to you most. Soups, smoothies, and shakes are especially important if you
are wired shut. Even patients who are not wired shut will likely favor a more liquid/puree diet the first
week or two after surgery.

We also recommend that you supplement your diet with multivitamins. Instant breakfast drinks and
protein powders are a good source of protein and calorie supplementation.

A weight loss of 10% may be anticipated following surgery. This is more a reflection in loss of appetite
rather than the teeth being rubber-banded together. Once your diet returns to normal, you will regain your weight
within a few weeks. It is also extremely important to take in plenty of fluids (over a gallon is ideal),
because dehydration can result in nausea and vomiting and more importantly, can affect the bone
healing. Use the color of your urine as a guide, if it starts getting dark, you are behind and need to
increase your fluids significantly!!

Remember, biting into foods could cause displacement of the healing jaw segments.

DIET WHEN RUBBER-BANDED SHUT:
All foods must be blended and strained to remove food particles prior to drinking. Try nutritional
supplements such as Ensure, Boost, Carnation instant breakfast drinks (all are available in supermarkets
and drugstores). Health-food stores carry ready-made milk shakes or protein powders that are easy to add
to milkshakes or juice. Other suggestions for on the go meals include canned juice such as V-8 splash or
fusion, milkshakes, baby food and food in a jar, as well as yogurt.

If you are taking vitamins before, continue to do so. Whole vitamins can be smashed in the cloth, with a
hammer and dissolved in juice.

Clean your mouth properly after each meal.

If you have lactose intolerance use lactose free milk or milk substitute such as soy or almond.

If diarrhea develops try decreasing milk and milk products. Call your surgeon if diarrhea persists.