Orthognathic Post-Operative Instructions
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Le Fort I Osteotomy (LF 1)
POSTOPERATIVE INSTRUCTIONS:
Sinus Precautions:
If you have undergone an operation involving the upper jaw you must remain on sinus precautions for at least 4 weeks:
- No smoking
- No nose blowing
- No closed nose or close mouth sneezing
- No straws
- No flying, swimming or scuba diving
Please attempt to sneeze with your mouth open. Do not try and hold the sneeze in but let it out naturally to avoid an increase in pressure. Please use the prescribed saline nasal spray as indicated. It is not uncommon to have post operative nose bleeds. If the bleeding cannot be controlled, have the on call Oral and Maxillofacial Surgery resident paged or go to the Montreal General Hospital emergency room.
Oral Hygiene:
It is important to maintain good oral hygiene postoperatively to prevent postoperative infection as well as dental decay and/or gum disease.
- Please rinse with chlorohexidine or Peridex rinse twice a day. Do not eat or drink for one half hour after rinsing.
- Perform warm salt water rinses regularly after eating. Wait one hour after chlorohexidine rinse before beginning salt-water rinses.
- Brush your teeth regularly. You may remove any elastics in place in order to thoroughly brush but be sure to replace them as instructed after brushing.
- You may use a water-pik device for oral cleaning if you own one. However, this is not necessary.
- No flossing. Because flossing may not be possible it is important to rinse and brush as mentioned above.
- Mechanical and manual toothbrushes alike are acceptable for postoperative dental care.
Activity:
After surgery you may not participate in strenuous physical activity or any activity that may result in trauma to the face for at least six weeks postoperatively.
- No strenuous running, weight lifting, etc.
- No contact sports.
Diet:
It is critical after surgery that you remain on a blenderized diet (non-chewing) for six weeks. All foods with consistency harder than applesauce must be placed in a blender prior to eating.
- Blenderized diet for six weeks.
- Avoid fat free foods for optimum nutrition and to avoid weight loss.
- Anything (even pizza and meats) that can be liquefied in a blender will help in the dietary intake. Additional dietary supplements may include Carnation Instant Breakfast, Ensure, etc.
Antibiotics:
If you have been prescribed an antibiotic, it is very important that you take it as directed until the prescription is complete or until otherwise instructed by our surgery team.
Pain and Swelling:
For moderate-severe pain, you can use the prescribed narcotics. These should not be taken on an empty stomach as they can cause nausea/vomiting. They may also cause drowsiness and constipation. Do not drive while medicated. For constipation, you can buy over-the-counter Colace/Docusate Sodium or a stool softener. Pain and swelling are usually highest at 48-72 hours postoperative. After that period pain should continue to decrease and you can use either Tylenol or Ibuprofen for mild-moderate pain. You can also apply ice to the face frequently for the first 2-3 days postoperative to decrease swelling and improve comfort. Use the ice packs 20 minutes on / 20 minutes off or alternate from side to side every 20 minutes. Sleeping in a semi-upright position in bed can reduce swelling. Using two pillows is usually adequate for this.
Nausea:
This is usually due to swallowing a small amount of blood during and/or after surgery. A small amount of carbonated drink, such as 7-Up or ginger ale, every hour for 5 or 6 hours will usually relieve this feeling. Sometimes pain medications can cause nausea. If your jaws are shut with wires or elastics, nausea is no cause for alarm. Remember that even if you should become nauseated and vomit, everything that is in your stomach has been strained through your teeth and can easily pass back through. If your nausea is persistent, please call our office.
DO NOT SMOKE.
Smoking post-operatively may lead to the following:
-Malunion of reduced bone and/or intraoral wounds
-Delayed wound healing
-Necrosis of the bone, leading to:
-Resection or removal of bone
-Bone Grafts
-Additional surgeries
-Infection
-Increased postoperative pain
You may contact us with questions or concerns at 514-934-8397.
In the event of an emergency please contact emergency medical help. You may also contact the oral surgeon on call by calling the hospital operator at 514-934-1934 ext. 53333 and requesting the oral surgeon on call. An on-call oral surgeon is available for emergent issues 24hrs a day 7 days a week.
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Bilateral sagittal split osteotomy (BSSO)
POSTOPERATIVE INSTRUCTIONS:
Oral Hygiene:
It is important to maintain good oral hygiene postoperatively to prevent postoperative infection as well as dental decay and/or gum disease.
- Please rinse with chlorohexidine or Peridex rinse twice a day. Do not eat or drink for one half hour after rinsing.
- Perform warm salt water rinses regularly after eating. Wait one hour after chlorohexidine rinse before beginning salt-water rinses.
- Brush your teeth regularly. You may remove any elastics in place in order to thoroughly brush but be sure to replace them as instructed after brushing.
- You may use a water-pik device for oral cleaning if you own one. However, this is not necessary.
- No flossing. Because flossing may not be possible it is important to rinse and brush as mentioned above.
- Mechanical and manual toothbrushes alike are acceptable for postoperative dental care.
Activity:
After surgery you may not participate in strenuous physical activity or any activity that may result in trauma to the face for at least six weeks postoperatively.
- No strenuous running, weight lifting, etc.
- No contact sports.
Diet:
It is critical after surgery that you remain on a blenderized diet (non-chewing) for six weeks. All foods with consistency harder than applesauce must be placed in a blender prior to eating.
- Blenderized diet for six weeks.
- Avoid fat free foods for optimum nutrition and to avoid weight loss.
- Anything (even pizza and meats) that can be liquefied in a blender will help in the dietary intake. Additional dietary supplements may include Carnation Instant Breakfast, Ensure, etc.
Antibiotics:
If you have been prescribed an antibiotic, it is very important that you take it as directed until the prescription is complete or until otherwise instructed by our surgery team.
Chin Dressing:
If you have a chin dressing, this should only be removed in 5 days after the operation. This is best done in the shower. Do not remove this any earlier.
Pain and Swelling:
For moderate-severe pain, you can use the prescribed narcotics. These should not be taken on an empty stomach as they can cause nausea/vomiting. They may also cause drowsiness and constipation. Do not drive while medicated. For constipation, you can buy over-the-counter Colace/Docusate Sodium or a stool softener. Pain and swelling are usually highest at 48-72 hours postoperative. After that period pain should continue to decrease and you can use either Tylenol or Ibuprofen for mild-moderate pain. You can also apply ice to the face frequently for the first 2-3 days postoperative to decrease swelling and improve comfort. Use the ice packs 20 minutes on / 20 minutes off or alternate from side to side every 20 minutes. Sleeping in a semi-upright position in bed can reduce swelling. Using two pillows is usually adequate for this.
Nausea:
This is usually due to swallowing a small amount of blood during and/or after surgery. A small amount of carbonated drink, such as 7-Up or ginger ale, every hour for 5 or 6 hours will usually relieve this feeling. Sometimes pain medications can cause nausea. If your jaws are shut with wires or elastics, nausea is no cause for alarm. Remember that even if you should become nauseated and vomit, everything that is in your stomach has been strained through your teeth and can easily pass back through. If your nausea is persistent, please call our office.
DO NOT SMOKE.
Smoking post-operatively may lead to the following:
-Malunion of reduced bone and/or intraoral wounds
-Delayed wound healing
-Necrosis of the bone, leading to:
-Resection or removal of bone
-Bone Grafts
-Additional surgeries
-Infection
-Increased postoperative pain
You may contact us with questions or concerns at 514-934-8397.
In the event of an emergency please contact emergency medical help. You may also contact the oral surgeon on call by calling the hospital operator at 514-934-1934 ext. 53333 and requesting the oral surgeon on call. An on-call oral surgeon is available for emergent issues 24hrs a day 7 days a week.
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Genioplasty
POSTOPERATIVE INSTRUCTIONS:
Please leave the chin dressing for 5 days after your surgery. During this time, you may shower, but please keep the chin dressing dry while showering. On the 5th post-operative day take a hot shower with steam and remove clear/xelophane dressing first. Then peel off the white sticky dressing carefully while holding your skin in place to avoid any skin damage/abrasion.
You may contact us with questions or concerns at 514-934-8397.
In the event of an emergency please contact emergency medical help. You may also contact the oral surgeon on call by calling the hospital operator at 514-934-1934 ext. 53333 and requesting the oral surgeon on call. An on-call oral surgeon is available for emergent issues 24hrs a day 7 days a week.
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