Dr. Neil Agnihotri is very passionate about jaw surgery. He is uniquely trained in Craniofacial Surgery (surgery of the face/skull) and has performed hundreds of cases. Jaw surgery provides a permanent solution to not only enhance facial aesthetics, but also to prevent pain and other defects down the road. Facial implants (chin/cheek) along with jaw surgery create a well-rounded facial and profile enhancement.
What is It?
A definitive treatment for open bites, under bites or people with jaw discrepancies.
2 weeks of initial healing, 5 weeks of complete healing.
Anesthesia: General anesthesia
Who is it for?
Teenagers / adults with jaw discrepancies.
The following information is provided to ensure that many of the details of postoperative care are covered prior to your surgical procedure. This ensures a smooth and uneventful recovery. It has been our experience that the more information and preparation patients have prior to their surgery, the more easily they are able to manage their postoperative care.
There are several aspects of your postoperative care which will require special attention. These areas of concern are listed below in the sequence with which you will have to manage them after your surgery.
It is difficult to predict what you will remember immediately following surgery. You may remember waking up in the recovery room or you may not recall this event and only remember waking up in your room. Regardless, be assured that there will be experienced and caring nurses and staff to attend to your needs. When you awake, you may have some concerns. You will likely have a small oxygen mask lightly over your face; this is routine. If you have some fluids in your mouth or stuffiness in your nose, this will be removed with a small suction tube. Remember – your jaws will be held together with some elastics-not wires. Many of these things can cause you to feel uncomfortable or even panicky. Remember to relax and listen to the staff – you are in no danger. Your jaws are not wired together and usually you will be able to open the jaws against the force of the elastics. We would prefer that you don’t. This resting of the jaw will help minimize swelling.
You will be positioned with your head up. This will help minimize swelling. This “head up” position should be used for the first 7-10 days to help reduce swelling. Expect the peak of your swelling to occur 48 hours after surgery and most should be gone by 7-10 days. In the hospital, the bed will be flexed in the middle to prevent you from sliding to the foot of the bed. At home, propping up your mattress at the head of the bed and under the foot of the bed will help also. Spending a lot of time in a “Lazy Boy” type chair is an excellent alternative. Remember, keeping your head above the level of your heart is what helps reduce and minimize swelling. How much swelling you will actually have varies significantly from patient to patient.
In the hospital, several additional aids will be used to help minimize your swelling. Medications will be administered to help decrease swelling. Ice packs will also be used. Constant use for the first 12 -24 hours is most effective. The nurses will assist you with ice packs which should be applied for 20 minutes and removed for 10 minutes.
Nasal swelling and stuffiness can also be a problem after upper jaw surgery. This will tend to be worse 48 hours after surgery and will then begin to decrease.
Warm packs to the face after the first 48 hours will help increase blood supply and reduce swelling, speeding the resolution of discoloration associated with bruising. If bruising occurs it will be evident 4-5 days after surgery.
Just a final word regarding your jaw surgery and safety. First, the elastics can be easily removed by you. In the unlikely even vomiting occurs, it is most important to position yourself properly rather than to try to take the elastics off. If you are sick, position yourself over a basin or toilet bowl and let the fluids pass between the spaces in your teeth and out your nose. You will not choke. There is no need for you to take wire cutters home with you.
Following jaw surgery there is frequently some numbness in the upper or lower lip, or both. When this is combined with facial swelling and soreness due to incisions inside the mouth, a task as basic as drinking may present difficulties. There are several tips which may help you:
- You should be drinking a fair amount of fluid after jaw surgery. Daily amounts should be between 2 -3 liters. Fruit juices are an excellent source of fluid, especially apple juice. This is a major goal after surgery. The most frequent cause for a delay in discharge from the hospital is a lack of adequate fluid intake. Always have some fluids in front of you and drink frequently to consume 2-3 liters in 24 hours. The nurses will be encouraging you to drink early.
- Attempt to drink from a cup if possible. While some fluids may be spilled when drinking in this manner, this is still the most effective way of taking fluids.
- Place a small towel under your chin if necessary and place a small amount of fluid in your cup. Tip your head back slightly while pouring in the fluid slowly, a little at a time. Close the lips together and swallow. If you have difficulty with this, then try doing it in front of the bathroom mirror over the sink. You will find this gets easier the more times you drink.
REMEMBER: TAKING ADEQUATE AMOUNTS OF FLUIDS IS ESSENTIAL FOLLOWING SURGERY
Several medications will be used around the time of your surgery. Antibiotics will be given during your hospital stay through the intravenous. Upon your discharge from the hospital, these antibiotics will be given in liquid form.
Pain medication will also be given after your surgery. In the first 24 hours following your surgery, the pain medication will be administered through intravenous. You will regulate the amount of pain medication you are given. It must be emphasized that this route of administration is only used while you have the intravenous, which is approximately 24 hours. We always encourage you to use oral pain medication as soon as possible as this will expedite your discharge from the hospital and allow for a smoother transition. Upon your discharge from the hospital, your pain medication will be in liquid form. In general, there is less pain than most would anticipate with this surgery. This is due to the dysfunction of the sensory nerve in the areas of surgery which minimizes your ability to feel discomfort.
This is an important part of your surgery. This will help balance your bite and train your muscles to function in the new jaw position. It has indentations on it that fit the teeth on the top and bottom and thus will only fit one way.
Generally, the splint will be worn continuously for the first 3-5 weeks following surgery. Your orthodontist may continue to use the splint for a short period of time to assist treatment. Failure to wear the splint may cause pain or may result in significant change of the bite! The splint will also help reduce jaw joint pain.
Jaw Joint Pain
It is possible to experience some pain or pressure in or around your jaw joint after jaw surgery. This may feel somewhat like an earache. This pain or pressure will usually disappear within 2 to 3 weeks. If the pain medication is not taking the pain away, let us know and an anti- inflammatory medication may be prescribed. The new position of your jaw is the cause of pressure in the jaw joint area.
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