How is the postoperative period after orthognathic surgery?

Orthognathic surgery allows us to correct the inadequate bony position of the jaws which, apart from being an aesthetic problem, can become a functional problem and lead to other pathologies that can condition our lives.

As it is a facial intervention, it usually causes inflammation for 72 hours, because during the surgery it is necessary to move the muscles of the face to access the bone area where the relevant cuts are made. On the other hand, the tissues of the lips are subjected to movements in order to expose the bone and proceed with the surgery.

Generally, the postoperative period after surgery is uncomfortable during the first week, but after the second week it starts to become easier.

How will the recovery be after orthognathic surgery?

Once the operation is over, the patient is placed in a cryotherapy mask, which allows the inflammation to be controlled. During the first hours, it is advisable not to get out of bed due to the effects of general anesthesia.

Generally, during the first week the doctor indicates a treatment to be followed with antibiotics, analgesics, anti-inflammatories, gastric protectors and chlorhexidine mouthwash for rinsing.

Effects upon awakening after orthognathic surgery

  • Nasal bleeding: there is a possibility of nasal bleeding, especially during the first 24 hours, due to the osteotomy performed in the upper jaw at the level of the maxillary sinuses, because these are in contact with the exterior through the nose.
  • Nasal congestion: the mucosa of the nose is swollen.
  • Edema and hematoma: the patient will present swelling during the first three days.
  • Sore throat: the patient remains intubated during the operation, so it is normal to have a sore throat, caused by the anesthesia tube.
  • Hypoesthesia of the lip and chin: the inflammation compresses the nerve and causes a poor sensory quality in the whole area from the lip to the chin.

Postoperative guidelines for orthognathic surgery

The day after surgery, the doctor will give the patient hygiene instructions:

  • Do not blow your nose: it is possible that your nose may bleed, so it is important to clean it using ear swabs soaked in hydrogen peroxide. In this way, all the dirt can be removed.
  • Brushing after orthognathic surgery: it is important to brush after every meal with a soft brush for the stitches and a medium brush for the teeth.
  • Diet: during the first week the diet should be liquid, such as broths, fruit shakes, energy shakes, etc. From the second week onwards, a soft diet can be followed and from the third week onwards, a normal diet can be followed, avoiding harder foods.
  • Sports: during the first three months, no physical contact sports should be practiced. It is important to do gentle exercise and avoid cardio during the first weeks.
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Physiotherapy for the postoperative period

After surgery, the muscles lose a lot of tone, so it is very important to perform exercises to regain the tone, strength and mobility that have been lost due to surgery. If these exercises are not performed, recovery will be slower.

The physiotherapy treatment is essential to recover sensitivity and accelerate inflammation, affecting different points:

  • Muscles of mastication: after orthognathic surgery, it is essential to recover the muscle tone of the muscles involved in mastication to gain movement in the opening of the mouth.
  • Mobilization of the Temporomandibular Joint (TMJ): to gradually open the mouth.
  • Lymphatic drainage: this surgery does not leave external scars, but it is aggressive, so that hematomas and edema will appear on the face, neck or upper chest. Lymphatic drainage can decongest the area, helping to regenerate damaged tissues and thus reducing both edema and hematoma.
  • Trigeminal nerve release: this nerve innervates the muscles of mastication, therefore, it is essential to release this nerve to normalize muscle tone.
  • Exercises: it is important to carry out exercises to strengthen facial muscles and facial mimicry in front of a mirror, in order to recover all facial movements.