Jaw Surgery FAQ
I hear many of the same questions asked in a lot of different forums and online groups, so I figured I would make a section dedicated to some of them and try to provide answers for people doing their research on everything. Full disclaimer: I am not a medical doctor. This is not the advice of a medical doctor. This is only my take on my experience through two jaw surgeries with two different surgeons as well as what I've seen across the online community over the years. Feel free to use these questions to take to your surgeon and get answers for what to expect for your individual case.
Will I be wired/banded shut? Sometimes yes, and sometimes no. Depends on what the SOP is for your surgeon. I'd say most cases it's a yes.
Will I have a splint? Same as above. Sometimes yes, and sometimes no. My first surgery I had no splint. For revision I wore a splint for 4 weeks while banded shut. I feel like multiple piece leforts for sure see a splint after.
Will I have permanent numbness? This is one of the main risks of jaw surgery, especially lower. I feel like upper permanent numbness is pretty rare. My first surgeon said she's never had a patient end up with permanent numbness in upper areas. With lower it's higher risk and the risk increases as you get older and the nerves lose their elasticity. It's also increased risk if you are a revision since the nerve has lost elasticity and has scar tissue build up from the first surgery. At first though, you can expect to be pretty damn numb (not always, but it's a good chance). I feel like every now and then there is a patient who actually wakes with no numbness, but majority have numbness anywhere from the eyeballs down. It doesn't have to be symmetrical either. My first surgery I was numb from my eye down on my right side, but completely fine on my left. Feeling can take many months to come back but rule of thumb is whatever you have left after 12 months is probably going to be what you're stuck with.
Will I be swollen? Bruised? How long? Again, something that varies patient to patient and can't be predicted well since everybody is different. You very may well resemble a prize fighter like mister potato head your first week or two post op. Most people see the first huge drop off in swelling/bruising after 1-2 weeks. Swelling usually peaks days 2-4 and begins to recede after. Some residual puffiness may stick around for months though. Bruises will look worse before they start to look better, and then eventually fade to an yellow/green. You may see that color running down your throat as things continue to drain/heal in your face. I find a lot of patients who had upper jaw surgery hold on to some puffiness around the nose/cheeks the longest, but should subside in the 9-12 month time frame. I was puffy around my nose until about 9 months post op the first time, and feel like by 6 months post op revision that most of my lingering swelling was gone. Scar tissue can be stiff/tight and take months to settle out too. Rule of thumb is wait a year for everything to settle all together. Like everything else in this process, nothing happens quickly.
Will I be able to eat after surgery? This again varies from case to case and doctor to doctor. Some doctors allow you to take the bands off and go to soft chew right away, others want liquids/puree only, others even go further and say particle free liquids for the first few weeks. I was limited to broth the first two weeks while wired shut after my first surgery, and then for revision I was able to take my bands off and fit a squeeze bottle with thicker pureed food in between my teeth. I was cleared for soft chew after the splint came off 4 weeks post op. Each case and each doctor is different though, so best to check with your surgeon and see what they want you to do and follow their directions for you.
Will I be sick after surgery? What if I have to throw up while banded/wired shut? This usually depends on how you handle anesthesia. Some people get pretty sick from it. I got lucky in this respect. It doesn't effect me in the slightest there and for all intents and purposes, anesthesia is a pretty enjoyable experience for me just getting to float away and be asleep for the carnage. If you are sick though, don't fret. You'll only have liquids in your stomach to pass and this can pass through wires/bands easily.
Will I have to stay in a hospital? Most double jaw patients spend 1-5 days in the hospital (from my experience with patients in online groups). Sometimes lower jaw is done as an outpatient procedure. Same with SARPE. I spent 1 day in the hospital after both of my surgeries.
Is jaw surgery extremely painful? This is a subjective area and can vary patient to patient. I tend to have a high pain tolerance, so what I consider not painful may be terribly painful to somebody else and vice versa. My first surgery was not bad at all. I even cut off all pain medicine in the hospital (including anything like tylenol/advil/etc) and was completely off any meds by 4 days post op. Revision was more painful where I needed the narcotics in the hospital and the first day or so at home, but again by 4-5 days post op I was off of everything, even OTC advil and the like. I would describe it as more swelling/discomfort than acute pain.
Will I need help after I get home from the hospital? Again, every case is different and depends on what you're having done. Lower jaw only might just need help briefly, especially if you don't have kids and stuff to take care of. Double jaw I feel like takes a little more out of you and a bit more time to come back from. I don't have any kids and still chose to fly my mom out to help take care of me for 3-4 weeks after surgery during the time I am not up for lifting much (like laundry baskets), cooking much, doing the grocery shopping, etc.
How long do I need off of work? Again, this varies case to case and what you're having done. Also depends on the demands of your job. Lower jaw bounces back quicker and I've seen people back to work a week or two post op. Double jaw can take longer. In my particular case, despite that I heal pretty quickly compared to a lot of others, I was out of work for 4 weeks the first time and 6 weeks after revision. My job demands that I speak clearly in front of groups I am presenting to, so as long as I was banded shut with a splint in I physically couldn't do my job to the full extent and had to be out. Even if I wasn't banded shut, I was so low on energy that it would have been difficult for me to jump right back to work full time anyway. 4 weeks was pushing it the first time, but it was doable. I could have done 3 if you held a gun to my head, but definitely not before that. Age also plays a factor here. Seems like the 20 year old bounces back quicker after double jaw vs. the 35, 40, or 50 year old.
Will I be able to talk wired/banded shut? Yes. If you look back at my blog posts after my revision surgery (February 2016 in the blog), there are a few videos of me talking banded shut in a splint. Talking wired shut with no splint was easier/clearer, but it was still doable in the splint. It takes effort though and it can get tiring very quickly.
How do I eat wired/banded shut? I had two completely different experiences with eating through my recoveries. First one I was old school wired shut and had a hell of a time getting anything more than water/broth consistency through my teeth/wires. Anything thicker and it would clog up all the nooks/crannies between the wires and brackets and I quickly felt like I couldn't breathe. For revision I was in the same posture the first 4 days post op. After my first check up on day 4, I was cleared to take my bands off to eat. I couldn't open enough to even get a finger in, but I was able to open enough to get the tip of a condiment squeeze bottle in, so anything I could puree in to that squeeze bottle was fair game to go in to my mouth to eat. This was a huge game changer and I was able to consume a lot more calories that helped me heal better. I dropped a lot less weight the second time for this reason too.
Will I need a new ID/passport picture after surgery? No. Even with super dramatic changes, I seriously don't think this is an issue and wouldn't trip all over myself to go through all of the hassle for a new passport. Passport pictures are usually no smile mug shot pictures anyway. While you may look quite different to you when you look in the mirror, the CBP agent looking at this little picture won't be able to tell the difference in the least.
Can I travel after jaw surgery? You're not going to have the energy to do anything immediately after surgery. You'll be laid up for a few weeks. I've seen some patients, who flew somewhere else to have their surgery done, fly home as early as 4 weeks post op, but this is something that will vary surgeon to surgeon. I flew as early as 8 weeks post op after my first surgery.
Can you breathe normally after surgery? Yes. Even when you don't feel like you are, you are getting full air in. If you had upper jaw surgery your nose can be incredibly clogged with a bunch of epic blood and snot. You may have periods where you feel like you can't breathe, but I assure you you're probably close to 100% if you were wearing a pulse ox. Both of my surgeons gave me saline spray and affrin to use in isolation when it got really bad. Otherwise hot showers or putting your head over a bowl with steaming hot water and a towel over you may provide some relief in terms of opening your sinus up for a bit.
How long can you not blow your nose after upper jaw surgery? Again, varies from doc to doc. My first surgeon wanted me to wait 6 weeks. My second surgeon was OK blowing softly by 2 weeks post op I think. This is also another "see what your surgeon says" things. Even if you don't blow, you may have some nose bleeds. This is normal after upper jaw surgery.
Will I have plates/screws? Do they ever get taken out after? Will I set metal detectors off? Most jaw surgery patients get some form of rigid fixation now in the form of plates/screws/pins/etc. They are meant to stay in for the rest of your life unless you have issues with the hardware backing out of the bone, becoming infected, or otherwise causing some kind of pain/discomfort. In that case your surgeon may have to go in and take them back out. It's a minor procedure that can usually be done in office under local anesthetic and sometimes under a little IV sedation, and recovery is much quicker than the original jaw surgery. And no, you won't be setting any metal detectors off and you won't have any issues with an MRI (but it's still good to advise the MRI techs that you do have hardware in your face).
Will jaw surgery change the way that I look? Sometimes yes and sometimes no. I feel like class III patients have the most dramatic changes, and depending on what your discrepancy is class II, it's hit or miss what you can see from jaw surgery. First and foremost the surgeon is there to fix your functional bite problems. Anything in terms of soft tissue changes is not guaranteed and can't be predicted with high confidence. Depending on what you're having done, it's possible your face shape could change, your profile may be different, and depending on what upper jaw work is being done, even the shape of the nose can change. I've seen class III's with a hooked nose totally come out with flat symmetric noses after surgery. Again, nothing is guaranteed here, so I caution people approaching this surgery with a very specific vision in mind of how the soft tissue will look afterwards to really be careful going in to surgery with that. You may not get that specific vision you have in your mind and you will end up with regret, even if you have excellent results otherwise.
How do I take medicine with my jaws wired/banded shut? Your surgeon will probably give you any medicine in liquid form. I had liquid pain meds and antibiotics to go home with.
How do I keep my mouth clean while wired/banded shut? Your surgeon may prescribe you a mouth wash to use. My first surgeon gave me Peridex, which stained the hell out of my teeth. My revision surgeon told me to just use 50% water and 50% peroxide. This worked great for me. He also gave me a syringe to gently flush out any food particles out of my incisions and I used it to flush my splint too. My first surgeon didn't do that and I had a lot of food stuck in my wounds. You can buy a baby tooth brush to gently brush what you can. It's hard to get everything so it's OK if you can only get to the front of your mouth and not get the back well. I just used the head of my sonicare to brush with and that worked out well, first only doing the front, and slowly and very carefully getting as far back as I could. Be careful to avoid pulling any stitches or anything in the back-- easier said and then when you're numb and swollen and can't feel what is what back there. I liked the 50/50 mouth wash so much that I continue to do it as part of my daily dental care routine now.
When can I work out again after surgery? Again, this is for sure something to ask your doctor about. Typically surgeons want you to wait 6-8 weeks for the bones to initially set. Both of my surgeons said 6-8 weeks.
Can you sleep laying down after surgery? I think most surgeons suggest you sleep elevated your first few weeks post op. I bought a lazy boy recliner to sleep in the first few weeks, then moved to my couch to lay my head up on the arm rest at the end, and then after a week or so there, finally in to my normal bed again. Even then I still had some discomfort sleeping on my side, and saw a little increase in my swelling after I woke up from laying my head flat all night. I think my face was sore on my side for a couple months post op. Some people just go straight to their bed but use a ton of pillows or a bed wedge thing to prop themselves up on. The lazy boy worked out really great for me through both of my surgeries.
What about kissing.....and stuff? ::insert school girl giggle here:: Again, ask your surgeon. Trust me, they've heard it 1000 times before. You won't be the first, and you won't be the last to ask about this. You won't have an issue the first few weeks because you're going to feel like a train wreck. You're not going to be all sexy sexy make out mode, trust me. When the time comes, try it. Do what makes you comfortable. If you're having pain/discomfort, then listen to your body and stop. My husband was afraid he would break me for a while after surgery. It was quite comical. In terms of oral sex, this is especially an area to ask your surgeon. I've heard some surgeons go as conservative as saying wait a whole year post op while your joints settle and remodel, and some say go for whatever feels OK for you as soon as you want. My first surgeon said 6-8 weeks, another surgeon I consulted with said a year, and I never even bothered asking my revision surgeon.
When can I drive after surgery? My first surgeon made me wait two weeks until I was unwired. After that I was cleared to drive. My revision surgeon said when I felt comfortable and was off all pain meds, saying it's usually about a week for most of his patients. That was true for me. I think I started driving around day 10, but was still really foggy and out of it. I would have been more comfortable waiting 2 weeks probably.
How long do I have to use ice packs? What about heat packs? You'll probably have a jaw bra with ice in it while you're in the hospital. Typically surgeons have patients ice the first 2-3 days post op. I've only heard of one surgeon who is pretty well known and doesn't have his patients ice at all, even immediately post op. So, ask your surgeon what he/she does with this. My first surgeon just had me ice the first few days. I went to heat on my own and it was SO relieving. My revision surgeon said ice the first day or two and then go to warm moist heat, like a rag out of boiling water. I bought gel packs you can throw in the freezer OR microwave. They're pretty awesome and felt really good.
My surgery is coming up and I am REALLY anxious-- what should I do? Talk to your surgeon about this. Be honest about your level of anxiety you may be experiencing. It's OK to be anxious! You're about to have a MAJOR procedure to rearrange the bones in your face. I think surgeons expect most people to have some anxiety over this. Both of my surgeons gave me a prescription for something like xanax or valium. Make sure to check with your surgeon and/or anesthesiologist what you can take the night before or on your way to the hospital.
Can I smoke while wired/banded shut? Try your best to cut the smoking down before surgery. Easier said that done, I'm sure. You won't be able to smoke immediately post op. It's not good for the incisions and everything and it will slow your healing and could cause infection. Overall it's just not good for you, so in that initial healing period, try to lay off the smokes. If you believe you'll have trouble, try loading up on some patches or worst case scenario I would guess that a vaporizer is better than a traditional cigarette.
When can I drink alcohol again? In general you don't want anything acidic in your mouth while the incisions are initially healing. So you can probably lay off something like wine and some mixed drinks for a while. In general your doc is probably going to tell you to nix the drinks until you're off of all pain meds and also while you're not getting a ton of calories in. I feel like I took a break for 2-3 weeks post op after both of my surgeries. When I was feeling better and able to get more food in, I treated myself to a beer or a glass of wine if I was hanging out with friends or something.
What do I need to bring with me to the hospital? I way over packed the first time. The second time I imagine was more like how a woman giving birth would go to the hospital for her second vs. her first... I brought only the necessities. Since I was only staying one night, for me that meant dressing in something comfy to get there, IE: sweats or leggings on the bottom, and a button/zip up or pull over on the top that has a large hole so you can fit your swollen head through it without punching yourself in the face and all. I just put the same clothes on to go home in that I showed up in. I spent the whole 24 hrs at the hospital in a gown for the most part. I did bring PJ's just in case (same deal, something easy to pull over your tender swollen face). I brought a hand mirror for eating/drinking, hand towel, balm to put on my lips, fuzzie socks/slippers to wear in case I got cold, my phone/charger, brush, tablet (which I didn't have any energy to even look at), and a white board just in case I had trouble speaking (they really discourage you from using this, but it was a just in case thing for me). If you will have a multi day hospital stay, I'd say bring a few changes of clothes, PJ's, and your baby toothbrush or whatever you plan to use to clean.
For the ladies: What if I have my period during surgery? I actually altered the way I took my birth control so I could push my period back for my first surgery. I didn't feel like dealing with it, but I've heard from other ladies that it's not a huge deal. Usually you're stark naked under the hospital gown (in case you need to be cath'd or whatever else they may need to do), but they'll give you a pair of granny panties and pads to wear for surgery.
What kind of vitamins/supplements are good to take? I see this question asked a lot, and honestly the answer is different strokes for different folks. There are big things thrown around about arnica and bromelain being really great for post op swelling. Or B12 being good for nerve generation. Who knows what really helps and what doesn't. I was tempted to do a controlled (or somewhat controlled) study and not take anything my second surgery and compare that to how my swelling and healing was for the first. I didn't do it for two reasons: 1.) If I can take anything that can possibly help me heal from an invasive surgery, then I am going to take it. 2.) I would have foregone number 1 IF number 2 wasn't going to be a problem, which is this is not a perfect vacuum to compare surgeries. A revision is going to cause more trauma, more swelling, longer healing, etc. So, it's apples to oranges in comparison and it would not have been a good indicator to judge if the supplements were the difference or not. So, I took them. And I still take a lot of them. I took arnica, bromelain, tumeric (all natural anti-inflammatories to help with the swelling. I also rubbed arnica gel/cream on my face as well.), fish oil, multi vitamin, probiotic, joint move supplement, acetyl L carotene (recommended from a friend for help with nerve healing), B12, vitamin D, fiber powder and power greens powder to dissolve in some juice, and collagen peptide powder to dissolve in liquid as well. Not all of these come in powder form, so I had to wait until I could get my mouth open to take pills again for a lot of it. For my age and what I had done I still feel like I didn't swell as much as most and bounced back pretty fast. Is it my natural healing? Was it the supplements? Who knows, but you've got nothing to lose by trying them.....except wasting some money and making some expensive pee. Huge disclaimer here: Talk to your surgeon about EVERYTHING you're taking. They are more than likely going to tell you to stop taking most of it at least 2 weeks pre op since some of these things can increase bleeding.
Will I be wired/banded shut? Sometimes yes, and sometimes no. Depends on what the SOP is for your surgeon. I'd say most cases it's a yes.
Will I have a splint? Same as above. Sometimes yes, and sometimes no. My first surgery I had no splint. For revision I wore a splint for 4 weeks while banded shut. I feel like multiple piece leforts for sure see a splint after.
Will I have permanent numbness? This is one of the main risks of jaw surgery, especially lower. I feel like upper permanent numbness is pretty rare. My first surgeon said she's never had a patient end up with permanent numbness in upper areas. With lower it's higher risk and the risk increases as you get older and the nerves lose their elasticity. It's also increased risk if you are a revision since the nerve has lost elasticity and has scar tissue build up from the first surgery. At first though, you can expect to be pretty damn numb (not always, but it's a good chance). I feel like every now and then there is a patient who actually wakes with no numbness, but majority have numbness anywhere from the eyeballs down. It doesn't have to be symmetrical either. My first surgery I was numb from my eye down on my right side, but completely fine on my left. Feeling can take many months to come back but rule of thumb is whatever you have left after 12 months is probably going to be what you're stuck with.
Will I be swollen? Bruised? How long? Again, something that varies patient to patient and can't be predicted well since everybody is different. You very may well resemble a prize fighter like mister potato head your first week or two post op. Most people see the first huge drop off in swelling/bruising after 1-2 weeks. Swelling usually peaks days 2-4 and begins to recede after. Some residual puffiness may stick around for months though. Bruises will look worse before they start to look better, and then eventually fade to an yellow/green. You may see that color running down your throat as things continue to drain/heal in your face. I find a lot of patients who had upper jaw surgery hold on to some puffiness around the nose/cheeks the longest, but should subside in the 9-12 month time frame. I was puffy around my nose until about 9 months post op the first time, and feel like by 6 months post op revision that most of my lingering swelling was gone. Scar tissue can be stiff/tight and take months to settle out too. Rule of thumb is wait a year for everything to settle all together. Like everything else in this process, nothing happens quickly.
Will I be able to eat after surgery? This again varies from case to case and doctor to doctor. Some doctors allow you to take the bands off and go to soft chew right away, others want liquids/puree only, others even go further and say particle free liquids for the first few weeks. I was limited to broth the first two weeks while wired shut after my first surgery, and then for revision I was able to take my bands off and fit a squeeze bottle with thicker pureed food in between my teeth. I was cleared for soft chew after the splint came off 4 weeks post op. Each case and each doctor is different though, so best to check with your surgeon and see what they want you to do and follow their directions for you.
Will I be sick after surgery? What if I have to throw up while banded/wired shut? This usually depends on how you handle anesthesia. Some people get pretty sick from it. I got lucky in this respect. It doesn't effect me in the slightest there and for all intents and purposes, anesthesia is a pretty enjoyable experience for me just getting to float away and be asleep for the carnage. If you are sick though, don't fret. You'll only have liquids in your stomach to pass and this can pass through wires/bands easily.
Will I have to stay in a hospital? Most double jaw patients spend 1-5 days in the hospital (from my experience with patients in online groups). Sometimes lower jaw is done as an outpatient procedure. Same with SARPE. I spent 1 day in the hospital after both of my surgeries.
Is jaw surgery extremely painful? This is a subjective area and can vary patient to patient. I tend to have a high pain tolerance, so what I consider not painful may be terribly painful to somebody else and vice versa. My first surgery was not bad at all. I even cut off all pain medicine in the hospital (including anything like tylenol/advil/etc) and was completely off any meds by 4 days post op. Revision was more painful where I needed the narcotics in the hospital and the first day or so at home, but again by 4-5 days post op I was off of everything, even OTC advil and the like. I would describe it as more swelling/discomfort than acute pain.
Will I need help after I get home from the hospital? Again, every case is different and depends on what you're having done. Lower jaw only might just need help briefly, especially if you don't have kids and stuff to take care of. Double jaw I feel like takes a little more out of you and a bit more time to come back from. I don't have any kids and still chose to fly my mom out to help take care of me for 3-4 weeks after surgery during the time I am not up for lifting much (like laundry baskets), cooking much, doing the grocery shopping, etc.
How long do I need off of work? Again, this varies case to case and what you're having done. Also depends on the demands of your job. Lower jaw bounces back quicker and I've seen people back to work a week or two post op. Double jaw can take longer. In my particular case, despite that I heal pretty quickly compared to a lot of others, I was out of work for 4 weeks the first time and 6 weeks after revision. My job demands that I speak clearly in front of groups I am presenting to, so as long as I was banded shut with a splint in I physically couldn't do my job to the full extent and had to be out. Even if I wasn't banded shut, I was so low on energy that it would have been difficult for me to jump right back to work full time anyway. 4 weeks was pushing it the first time, but it was doable. I could have done 3 if you held a gun to my head, but definitely not before that. Age also plays a factor here. Seems like the 20 year old bounces back quicker after double jaw vs. the 35, 40, or 50 year old.
Will I be able to talk wired/banded shut? Yes. If you look back at my blog posts after my revision surgery (February 2016 in the blog), there are a few videos of me talking banded shut in a splint. Talking wired shut with no splint was easier/clearer, but it was still doable in the splint. It takes effort though and it can get tiring very quickly.
How do I eat wired/banded shut? I had two completely different experiences with eating through my recoveries. First one I was old school wired shut and had a hell of a time getting anything more than water/broth consistency through my teeth/wires. Anything thicker and it would clog up all the nooks/crannies between the wires and brackets and I quickly felt like I couldn't breathe. For revision I was in the same posture the first 4 days post op. After my first check up on day 4, I was cleared to take my bands off to eat. I couldn't open enough to even get a finger in, but I was able to open enough to get the tip of a condiment squeeze bottle in, so anything I could puree in to that squeeze bottle was fair game to go in to my mouth to eat. This was a huge game changer and I was able to consume a lot more calories that helped me heal better. I dropped a lot less weight the second time for this reason too.
Will I need a new ID/passport picture after surgery? No. Even with super dramatic changes, I seriously don't think this is an issue and wouldn't trip all over myself to go through all of the hassle for a new passport. Passport pictures are usually no smile mug shot pictures anyway. While you may look quite different to you when you look in the mirror, the CBP agent looking at this little picture won't be able to tell the difference in the least.
Can I travel after jaw surgery? You're not going to have the energy to do anything immediately after surgery. You'll be laid up for a few weeks. I've seen some patients, who flew somewhere else to have their surgery done, fly home as early as 4 weeks post op, but this is something that will vary surgeon to surgeon. I flew as early as 8 weeks post op after my first surgery.
Can you breathe normally after surgery? Yes. Even when you don't feel like you are, you are getting full air in. If you had upper jaw surgery your nose can be incredibly clogged with a bunch of epic blood and snot. You may have periods where you feel like you can't breathe, but I assure you you're probably close to 100% if you were wearing a pulse ox. Both of my surgeons gave me saline spray and affrin to use in isolation when it got really bad. Otherwise hot showers or putting your head over a bowl with steaming hot water and a towel over you may provide some relief in terms of opening your sinus up for a bit.
How long can you not blow your nose after upper jaw surgery? Again, varies from doc to doc. My first surgeon wanted me to wait 6 weeks. My second surgeon was OK blowing softly by 2 weeks post op I think. This is also another "see what your surgeon says" things. Even if you don't blow, you may have some nose bleeds. This is normal after upper jaw surgery.
Will I have plates/screws? Do they ever get taken out after? Will I set metal detectors off? Most jaw surgery patients get some form of rigid fixation now in the form of plates/screws/pins/etc. They are meant to stay in for the rest of your life unless you have issues with the hardware backing out of the bone, becoming infected, or otherwise causing some kind of pain/discomfort. In that case your surgeon may have to go in and take them back out. It's a minor procedure that can usually be done in office under local anesthetic and sometimes under a little IV sedation, and recovery is much quicker than the original jaw surgery. And no, you won't be setting any metal detectors off and you won't have any issues with an MRI (but it's still good to advise the MRI techs that you do have hardware in your face).
Will jaw surgery change the way that I look? Sometimes yes and sometimes no. I feel like class III patients have the most dramatic changes, and depending on what your discrepancy is class II, it's hit or miss what you can see from jaw surgery. First and foremost the surgeon is there to fix your functional bite problems. Anything in terms of soft tissue changes is not guaranteed and can't be predicted with high confidence. Depending on what you're having done, it's possible your face shape could change, your profile may be different, and depending on what upper jaw work is being done, even the shape of the nose can change. I've seen class III's with a hooked nose totally come out with flat symmetric noses after surgery. Again, nothing is guaranteed here, so I caution people approaching this surgery with a very specific vision in mind of how the soft tissue will look afterwards to really be careful going in to surgery with that. You may not get that specific vision you have in your mind and you will end up with regret, even if you have excellent results otherwise.
How do I take medicine with my jaws wired/banded shut? Your surgeon will probably give you any medicine in liquid form. I had liquid pain meds and antibiotics to go home with.
How do I keep my mouth clean while wired/banded shut? Your surgeon may prescribe you a mouth wash to use. My first surgeon gave me Peridex, which stained the hell out of my teeth. My revision surgeon told me to just use 50% water and 50% peroxide. This worked great for me. He also gave me a syringe to gently flush out any food particles out of my incisions and I used it to flush my splint too. My first surgeon didn't do that and I had a lot of food stuck in my wounds. You can buy a baby tooth brush to gently brush what you can. It's hard to get everything so it's OK if you can only get to the front of your mouth and not get the back well. I just used the head of my sonicare to brush with and that worked out well, first only doing the front, and slowly and very carefully getting as far back as I could. Be careful to avoid pulling any stitches or anything in the back-- easier said and then when you're numb and swollen and can't feel what is what back there. I liked the 50/50 mouth wash so much that I continue to do it as part of my daily dental care routine now.
When can I work out again after surgery? Again, this is for sure something to ask your doctor about. Typically surgeons want you to wait 6-8 weeks for the bones to initially set. Both of my surgeons said 6-8 weeks.
Can you sleep laying down after surgery? I think most surgeons suggest you sleep elevated your first few weeks post op. I bought a lazy boy recliner to sleep in the first few weeks, then moved to my couch to lay my head up on the arm rest at the end, and then after a week or so there, finally in to my normal bed again. Even then I still had some discomfort sleeping on my side, and saw a little increase in my swelling after I woke up from laying my head flat all night. I think my face was sore on my side for a couple months post op. Some people just go straight to their bed but use a ton of pillows or a bed wedge thing to prop themselves up on. The lazy boy worked out really great for me through both of my surgeries.
What about kissing.....and stuff? ::insert school girl giggle here:: Again, ask your surgeon. Trust me, they've heard it 1000 times before. You won't be the first, and you won't be the last to ask about this. You won't have an issue the first few weeks because you're going to feel like a train wreck. You're not going to be all sexy sexy make out mode, trust me. When the time comes, try it. Do what makes you comfortable. If you're having pain/discomfort, then listen to your body and stop. My husband was afraid he would break me for a while after surgery. It was quite comical. In terms of oral sex, this is especially an area to ask your surgeon. I've heard some surgeons go as conservative as saying wait a whole year post op while your joints settle and remodel, and some say go for whatever feels OK for you as soon as you want. My first surgeon said 6-8 weeks, another surgeon I consulted with said a year, and I never even bothered asking my revision surgeon.
When can I drive after surgery? My first surgeon made me wait two weeks until I was unwired. After that I was cleared to drive. My revision surgeon said when I felt comfortable and was off all pain meds, saying it's usually about a week for most of his patients. That was true for me. I think I started driving around day 10, but was still really foggy and out of it. I would have been more comfortable waiting 2 weeks probably.
How long do I have to use ice packs? What about heat packs? You'll probably have a jaw bra with ice in it while you're in the hospital. Typically surgeons have patients ice the first 2-3 days post op. I've only heard of one surgeon who is pretty well known and doesn't have his patients ice at all, even immediately post op. So, ask your surgeon what he/she does with this. My first surgeon just had me ice the first few days. I went to heat on my own and it was SO relieving. My revision surgeon said ice the first day or two and then go to warm moist heat, like a rag out of boiling water. I bought gel packs you can throw in the freezer OR microwave. They're pretty awesome and felt really good.
My surgery is coming up and I am REALLY anxious-- what should I do? Talk to your surgeon about this. Be honest about your level of anxiety you may be experiencing. It's OK to be anxious! You're about to have a MAJOR procedure to rearrange the bones in your face. I think surgeons expect most people to have some anxiety over this. Both of my surgeons gave me a prescription for something like xanax or valium. Make sure to check with your surgeon and/or anesthesiologist what you can take the night before or on your way to the hospital.
Can I smoke while wired/banded shut? Try your best to cut the smoking down before surgery. Easier said that done, I'm sure. You won't be able to smoke immediately post op. It's not good for the incisions and everything and it will slow your healing and could cause infection. Overall it's just not good for you, so in that initial healing period, try to lay off the smokes. If you believe you'll have trouble, try loading up on some patches or worst case scenario I would guess that a vaporizer is better than a traditional cigarette.
When can I drink alcohol again? In general you don't want anything acidic in your mouth while the incisions are initially healing. So you can probably lay off something like wine and some mixed drinks for a while. In general your doc is probably going to tell you to nix the drinks until you're off of all pain meds and also while you're not getting a ton of calories in. I feel like I took a break for 2-3 weeks post op after both of my surgeries. When I was feeling better and able to get more food in, I treated myself to a beer or a glass of wine if I was hanging out with friends or something.
What do I need to bring with me to the hospital? I way over packed the first time. The second time I imagine was more like how a woman giving birth would go to the hospital for her second vs. her first... I brought only the necessities. Since I was only staying one night, for me that meant dressing in something comfy to get there, IE: sweats or leggings on the bottom, and a button/zip up or pull over on the top that has a large hole so you can fit your swollen head through it without punching yourself in the face and all. I just put the same clothes on to go home in that I showed up in. I spent the whole 24 hrs at the hospital in a gown for the most part. I did bring PJ's just in case (same deal, something easy to pull over your tender swollen face). I brought a hand mirror for eating/drinking, hand towel, balm to put on my lips, fuzzie socks/slippers to wear in case I got cold, my phone/charger, brush, tablet (which I didn't have any energy to even look at), and a white board just in case I had trouble speaking (they really discourage you from using this, but it was a just in case thing for me). If you will have a multi day hospital stay, I'd say bring a few changes of clothes, PJ's, and your baby toothbrush or whatever you plan to use to clean.
For the ladies: What if I have my period during surgery? I actually altered the way I took my birth control so I could push my period back for my first surgery. I didn't feel like dealing with it, but I've heard from other ladies that it's not a huge deal. Usually you're stark naked under the hospital gown (in case you need to be cath'd or whatever else they may need to do), but they'll give you a pair of granny panties and pads to wear for surgery.
What kind of vitamins/supplements are good to take? I see this question asked a lot, and honestly the answer is different strokes for different folks. There are big things thrown around about arnica and bromelain being really great for post op swelling. Or B12 being good for nerve generation. Who knows what really helps and what doesn't. I was tempted to do a controlled (or somewhat controlled) study and not take anything my second surgery and compare that to how my swelling and healing was for the first. I didn't do it for two reasons: 1.) If I can take anything that can possibly help me heal from an invasive surgery, then I am going to take it. 2.) I would have foregone number 1 IF number 2 wasn't going to be a problem, which is this is not a perfect vacuum to compare surgeries. A revision is going to cause more trauma, more swelling, longer healing, etc. So, it's apples to oranges in comparison and it would not have been a good indicator to judge if the supplements were the difference or not. So, I took them. And I still take a lot of them. I took arnica, bromelain, tumeric (all natural anti-inflammatories to help with the swelling. I also rubbed arnica gel/cream on my face as well.), fish oil, multi vitamin, probiotic, joint move supplement, acetyl L carotene (recommended from a friend for help with nerve healing), B12, vitamin D, fiber powder and power greens powder to dissolve in some juice, and collagen peptide powder to dissolve in liquid as well. Not all of these come in powder form, so I had to wait until I could get my mouth open to take pills again for a lot of it. For my age and what I had done I still feel like I didn't swell as much as most and bounced back pretty fast. Is it my natural healing? Was it the supplements? Who knows, but you've got nothing to lose by trying them.....except wasting some money and making some expensive pee. Huge disclaimer here: Talk to your surgeon about EVERYTHING you're taking. They are more than likely going to tell you to stop taking most of it at least 2 weeks pre op since some of these things can increase bleeding.