Orthognathic Surgery

Our office will arrange with you the date, place and time of your admission to the hospital for surgery. 

Pre-operative Evaluation

Before admission, a history and physical exam will be completed. The primary intent of this examination is to screen patients for any potentially complicating systemic diseases. Should questions arise as a result of this examination, appropriate consultations will be conducted. Laboratory examinations, such as blood and urine tests will be obtained. In some patients, an EKG and or chest X-ray may also be ordered.

Anesthesia

At midnight of the evening before your admission, you will be instructed not to eat or drink anything (including water) until after the operation. This will insure that your stomach is empty and help prevent nausea after surgery. On the day of admission, a member of the anesthesia department will discuss the type of anesthesia planned as well as any potential complications that may occur.

Day of Surgery

Because general anesthesia is necessary, a breathing tube (endotracheal tube) will be placed through your nose and into your windpipe (trachea). This is done after you are asleep and is removed before you are completely awake. The IV will remain for the next 24 hours in order to allow antibiotics and anti swelling medicine to be given. You may also receive pain medication intravenously.

Post-Surgical Period

Following completion of the surgery, you will be transferred to the Post Anesthesia Care Unit. There your recovery progress will be monitored closely by specialized nurses. You will remain in the PACU until you are sufficiently awake at which time you will be transferred to your room. This usually takes 1-2 hours. Dr. Le will update your family in the surgical waiting room to answer any questions regarding your surgery. 

Swelling

You may anticipate that swelling will occur and the degree of swelling is quite variable among individuals. Swelling increases most in the first 36 hours but continues for 72 hours. About 80% of the swelling will resolve in the first week. The remainder may take several weeks to return to normal. 

Bleeding

A small amount of bleeding is normal. You will have up to 3 to 4 times the normal amount of salivary flow. A small amount of blood in that volume of saliva may concern you, but actually represents little blood loss. Also, upper jaw surgery takes place through the sinuses which collect small amounts of blood. Over the first post-operative week, what appears to be a bloody nose is actually the sinuses cleaning themselves of the bleeding at the time of surgery.

Nasal Congestion

Nasal congestion occurs as a result of the breathing tube placed to ensure your airway. You will be given a nasal spray post-operatively which should be used twice daily. The congestion usually resolves in the first week following surgery. 

Pain

Your pain medication regimen will be discussed with you by your surgeon.

Oral Hygiene

You will be given a prescription strength mouth rinse which should be used twice daily. You should also use a pediatric soft toothbrush to clean your teeth and appliances. Do not use a “water pik” for at least three weeks after surgery. When your elastics are off for meals and before bedtime is the optimum time to clean your mouth. Please do not use any other mouth rinse other than the one prescribed to you.

Diet

Initially you will be given clear liquids in the hospital to allow your stomach to resume normal function. Your diet will be advanced to a full liquid diet as you begin to remove your elastics. If the food can be easily mashed with a fork or is as soft as jello, it is ideal. Protein may be obtained from fish and dairy products. Mashed or blended foods also work well. 

Day of Discharge

Most patients will be discharged from the hospital the day after surgery. Your follow-up appointment at the office will be scheduled within the week.