Orthognathic surgery is performed in the hospital operating room under
general anesthesia. Most patients will stay in the hospital for 24-48 hours
after surgery for initial post-operative care. After discharge, the patient will
normally be seen in the office within 72 hours for post-operative x-rays
The amount of pain and discomfort experienced by patients prior to orthognathic surgery varies case by case. However,
considering the nature of the surgical procedure performed, many patients relate their pain levels immediately after surgery
to be lower than when they had their wisdom teeth removed. This perception of pain is due to the numbness in the
patients’ face, lips and gum tissue from the sensory nerves being stretched during surgery as well as being administered IV
pain medications. Prior to discharge from the hospital, patients are transitioned to oral pain medications, typically a
combination of an anti-inflammatory and narcotic. Patients are advised to use the narcotic only as needed, which is typically
Post-operative swelling causes most of the discomfort an orthognathic patient feels after their surgery. The amount of
swelling each patient has is variable patient to patient. As with most surgeries, you should expect swelling and discomfort
to peak 24-48 hours after surgery. To help with this discomfort, a large dose of IV steroids are administered to control
swelling of the face and neck region and a steroid cream is applied to counteract swelling of the lips. Pressure dressings
and ice packs are also used, but expect some bruising to accompany the swelling. Both swelling and bruising will gradually
resolve over the course of 2-3 weeks.
Many patients will exhibit intermittent oozing from the incisions for up to one week after surgery. Rinsing with warm salt
water helps cleanse the area and keep it clean as well as rids the mouth of any undesirable tastes. Patients that have had
upper jaw surgery will often experience an intermittent bloody nose for several days after surgery. These patients may also
notice blood clots draining from their sinuses for several weeks after as well. To help stop the drainage, pack the nostrils
with gauze or cotton packs. Patients with stuffy sinuses can use a humidifier or sit in a steamy shower to help facilitate the
drainage. If you experience excessive bleeding, please call our office.
For most orthognathic surgery patients, we ask you to refrain from any food requiring chewing for 6 weeks. This includes
any food that cannot be easily broken up with a fork. It is very common for patients to lose weight after surgery due to this
strict liquid diet. To keep your strength and energy up for the healing process, you will likely need to eat multiple small
meals throughout the day. It is also very important for the healing process that you drink plenty of fluid. We have plenty of
recipes to help you vary your food options during this time, if interested.
Many patients experience a sore throat for several days after surgery. This is typically related to the breathing tube used
for anesthesia during surgery. In most cases the sore throat resolves during the first week.
In most instances, long-lasting dissolving stitches are used. This particular type of stitch will typically start to come out after
10 days. However, if a stitch or knot is bothering you after 1 week, you may simply cut it off or call the office to have it
removed. Dr. Schock usually removes these loose sutures at your post-operative visits.
Most orthognathic surgery patients have small titanium plates and screws inserted at the time of surgery to help hold the
bones in place. These plates are under the gum tissue and are usually permanent. In addition, some patients who have
had upper jaw surgery will have a plastic splint fixated to the roof of their mouth to provide additional stability. This splint is
removed after 6 weeks. Elastics (or rubber bands) are usually placed at the time of surgery to help train you to bite in your
new position as well as help maintain the position of the jaws. The number and position of elastics will vary and are
changed throughout your recovery. Dr. Schock will advise you on how to change the elastics at your post-operative visits.
Many patients experience numbness in their lips, chin, gum tissue, roof of the mouth and under their eyes after
orthognathic surgery. This is usually a temporary condition which gradually decreases over the course of 2-4 months.
However, there have been cases of patients who experience permanent numbness or tingling sensations distributed in one
or more of the affected nerves. Most patients with this condition adapt quite well without any functional problems.
You will be prescribed an antibiotic, pain medication, anti-inflammatory and an antibacterial mouth rinse. You will be given
specific instructions on how to use each medication prior to discharge from the hospital. Please call our office if you have
any questions about these instructions.
Most patients require 2 weeks off from school or work after orthognathic surgery. Due to the effects of anesthesia, general
weakness from the surgery as well as potential drowsiness from the pain medication, you should be prepared not to drive
for 1 week after surgery. You must also avoid strenuous physical activity and contact sports for 6 weeks. Dr. Schock will
provide you with any work/school/sport release forms you require during this time.