What to Expect After Corrective Jaw Surgery
Weeks 1–4:
Typical Office Visits Include:
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General examination
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Cleaning of teeth, brackets, and wires if necessary
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Discussion about diet, oral hygiene, and physical activity
Office Visit Schedule:
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Typically two office visits the first week after surgery, then once a week
Weeks 5–7:
Once your jaws are no longer restricted by either wires or heavy elastics you will be able to appreciate and become accustomed to the improvements in your occlusion (bite) and breathing. However, it will take a little time to get used to your new occlusion. Remember your brain still thinks your jaws are in their pre-surgical position.
Typical Office Visits Include:
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General examination
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Placing guiding elastics
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Occlusal equilibration (minor adjustments in tooth shape)
Office Visit Schedule:
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Typically one office visit per week
After week 7:
Typical Office Visits Include:
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General examination
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X-rays
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Photographs
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Occlusal equilibration (minor adjustments in tooth shape)
Office Visit Schedule:
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Typically an office visit every several weeks until week 12
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Then every three months
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Then every six months for up to 1–2 years after surgery
Swelling
There is still a small amount of swelling that will take six months to one year to completely resolve. Although your new facial appearance can be appreciated, subtle changes may continue to occur in all areas of the face as the final swelling continues to resolve.
Facial Appearance
Corrective jaw surgery will typically restore the teeth, lips, and soft tissues of the face to a more normal position. It is important to understand that small changes may also occur in the surrounding tissues of the face including the nose, cheeks, lips, chin, and neck.
Changes in nose
Especially with procedures that move the upper jaw in any direction. Subtle changes in the nose might include a slight change in width, position, rotation, and overall appearance.
Changes in Cheeks
Especially with procedures that move the upper jaw in any direction. Subtle changes in the fullness of the cheeks may be noticed.
Changes in the mandibular angle
Especially with procedures that move the lower jaw in any direction. Subtle changes may include a slight change in the width, size, and shape of the lower jaw.
Changes in Lips
Changes may occur in the position, appearance, and/or function of the lips.
Changes in the chin
Especially with procedures that move the lower jaw in any direction, changes may occur in the position and appearance of the chin.
Changes in the neck
Especially with procedures that move the lower jaw in any direction. Subtle changes may occur in the fullness of the neck.
Timeline of Corrective Jaw Surgery
It is important to understand that your treatment, which typically includes orthodontics before, during, and after surgery, may take one to several years to complete. Your facial surgeon and orthodontist understand the practical and emotional difficulties that such a long term commitment presents for you and your family.
Pre-Operative Orthodontics
Before your surgery, orthodontic braces are used to move the teeth into a new position. Because your teeth are being moved in preparation for your “bite” after surgery, you may feel that your bite is getting worse rather than better. However, when your jaws are repositioned during surgery, your teeth will then fit together properly. This process will typically last 6–18 months; however, it may take longer for more advanced facial bone imbalances.
Pre-Operative Instructions (10 weeks prior to surgery)
Make sure to read and follow all pre-operative instructions at least ten weeks prior to your surgery (See Chapter 27)
“Final Wire” (8-10 weeks prior to surgery)
Once your orthodontist has finished the pre-operative orthodontics, a “final wire” will be place. This wire will maintain your teeth in their final pre-operative position. It will remain in position for 3–6 weeks prior to pre-operative planning. The actual amount of time will be determined by your orthodontist on an individual basis. A safe rule of thumb is to plan to have the “final wire” placed 10 weeks prior to your surgical date.
Pre-Operative Planning (3–6 weeks after the final wire has been placed)
After your pre-surgical orthodontic treatment is completed and the final wire has been in place for 3-6 weeks, new updated records will be taken. These records will be used to plan and guide your surgery. Acrylic splints, which help to guide the surgery, will be fabricated from these records and used at the time of surgery.
Splint Try-In (1–2 weeks prior to surgery)
Typically the splints fabricated during the pre-operative planning will be tried in 1–2 weeks prior to surgery.
Day of Surgery
Depending on the procedures, corrective jaw surgery may be performed in a hospital, an ambulatory surgical center, or in a surgical office. Surgery may take from one to several hours to complete.
Post-Op
After surgery, you may remain in the hospital for 1–3 days until you have recovered. Your surgeon will provide instructions for a modified diet, which typically begins with liquids and is slowly transitioned to a normal diet over 6–8 weeks. You will also be asked to refrain from using tobacco products and avoid strenuous physical activity. Surgery of this kind is noted for its lack of pain. There is discomfort, and some of the early post-surgery periods can be unpleasant due to swelling and jaw fixation. However, most patients do not complain of pain and typically do not require their prescribed pain medication. Swelling is common in the post-operative period. Typically facial swelling peaks on the third day after surgery and the major portion of swelling resolves in five to seven days. In some cases, your jaws will be closed together at the completion of surgery and may remain like this for up to four weeks.
While the initial healing phase is about six weeks, complete healing of the jaw bones takes between nine and 12 months.
Recovery
When Can I Return to Work?
Typically, you can return to non-physical work after two weeks. This would include attending classes and lectures, desk work, computer work, etc. This does not include anything that involves strenuous physical activity or prolonged speaking. If you do choose to return to work at this time it is important to make any necessary preparations to avoid creating a physically stressful situation. This may require precautions such as leaving class ten minutes early to allow enough time to arrive at your next class, enlisting someone to drive you and carry your books, computer, or any heavy objects, etc.
When Can I Return to Strenuous Physical Activity?
Strenuous physical activity is considered any activity that raises your heart rate. When your heart rate is elevated it will raise your blood pressure which can affect your healing. You may return to such activities after five weeks. Refer to chapter 28 for details regarding physical activity after surgery.
Post–Operative Orthodontics
Post-operative orthodontics may last from three months to a year or more. This decision depends on the type and degree of facial bone imbalance, and will be made by your orthodontist.