FAQ

I've tried to cover as many questions as I could think of to help other people, although these experiences are personal to me and shouldn't be taken as medically correct; it's important to remember that everybody is different and recovery varies in each individual. If you can think of anything to add, or want to ask anything that I haven't covered, feel free to comment below!

PRE-SURGERY QUESTIONS:

Did you have to have braces prior to surgery?
Yes, I had braces top and bottom during August 2009, and these have stayed with me until my operation, and will so for a while afterwards. They were used to move my teeth into their post-surgical position, and I had to meet with my orthodontist every 6-8 weeks for general adjustments of them.

Braces are also used during surgery to interlock surgical hooks which are put on just before surgery, and are used to hold elastics post-surgery.

What is the cost of jaw surgery?
As I live in the UK, I was covered by the NHS, so don't have a definitive answer for actual surgical costs. However, from research I know that jaw surgery will not be totally covered by insurance for cosmetic purposes only, however this all depends on your insurance plans and the type of work you are having done.
It's important to remember however that it is not soley for the cost of jaw surgery itself, you may have to pay for orthodontic treatment, braces, x-rays etc...

Did you have pre-surgery appointments?
Once my date had been set I had a variety of pre-surgical appointments. It is vital that you attend all appointments arranged for you, I was told that failure to attend could result in my surgery being cancelled.

Orthodontist: Once my date had been set, my orthodontist ensured that I had a variety of molds taken so that my surgical wafers could be fitted, and that I had upto date x-rays and photographs ready for my surgeons. Ontop of the 6-8 week general maintenance of my brace. My orthodontist also added surgical hooks to my brace ready for surgery.
Meet & Plan: This appointment was so that I could meet with my surgeons, and so that they could meet me on a more informal basis. They reviewed my bite, my face, appearance and all sorts that I probably don't know about. They sat me down and they told me exactly what they were going to do; they used models to show me where my incision lines would be and how exactly they would alter my jaw and chin. They also made sure that I was happy and all my questions were answered.
Clinic Appt: During my clinic appointment I met with my surgeon again who completed all of my pre-operative paperwork with me, in addition to going through the risks associated with this surgery (see below questions) and to sign consent forms. General questions about my health were asked, previous experiences of anesthetic, allergies, family history etc... ontop of general observations being checked (Blood Pressure, Heart Rate, Temp, Resp rate etc...). I also had to have bloods taken as a general check up, in addition to banking blood which could be cross-matched to determine blood type incase I needed a blood transfusion. As I was coming into hospital, I also had to have an MRSA swab.
Wafer Fitting: I had to meet with my surgeon a couple of times so that my wafer could be properly fitted. My final appointment was March 27th 2013; the day before surgery in which my wafer fitted exactly. My wafers were used to guide my jaws into their correct position during the operation.

POST-SURGERY QUESTIONS:

How long will surgery take?
This seems to be an avoided question with all surgeons; I remember my first ever surgeon telling me that it will take 'aslong as it needs to take.' Personally my surgery lasted for 6 hours.

How long will I be in hospital for?
I was admitted into hospital on Thursday, and discharged home from hospital on the Saturday, so had spent 2 nights and 3 days in hospital. Ideally my surgeon wanted to keep me for another couple of days but I desperately wanted to go home, to which he finally agreed. However it all depends on the preference of your surgeon, and if you've had single or double surgery; usually single jaw surgery is 1 night whereas double is 1-3 night.
It's important to remember though that you won't be discharged home if you're not fit enough. Prior to going home I had to show I was able to drink 2L of water per day, and atleast have a little bit of food. Additionally my pain had to be classed as 'under control.' From what i've read, not enough fluid intake is one reason why people have had to stay in hospital longer.

When can I return to school/uni/work etc..?
The simple answer to this is whenever you feel upto it. Personally I took 3 weeks off university, and I don't think I could have returned prior to then, even now I'm still in some level of discomfort and my energy is constantly low. My surgeon recommended 3-4 weeks, however, I've known people to go back only 1 week post-op. Keep in mind that you still need to eat and talk whilst at these places, and managing this is difficult in itself.

Will I feel nausea following surgery?
There is a strong probability you will feel sick following your surgery, due to a combination of medicines, a very empty stomach and swallowing blood during your surgery. Your surgeons and the nurses will provide you with lots of anti-sickness medication, and will be on hand to give you more if necessary. Personally for me, despite the anti-sickness I was sick (usually everytime I moved or attempted to drink) and from speaking to my parents and boyfriend I vomited around 1-1.5 litres of black, old blood. This resulted in me needing IV fluids alot longer than necessary.

What if I'm sick and i'm wired/banded closed?
Surgeons advise that you lean forward and let the sick flow through the gaps rather than attempting to take your bands off. I was banded closed with two bands, although I worried about this pre-op, my body just adapted and I was able to get out what I needed to. Your surgeon should however provide you with band or wire cutters incase of emergencies.

Will I be in pain/What pain medication will I take?
This is a hard question to answer as everybody experiences pain differently. While jaw surgery in itself isn't overly painful; you will experience pain, especially during your first week, if not into your second. You will also become accustomed to different types of pain: dull, aching, shooting and stabbing. Take your pain medication as often as you can, and as often as it is prescribed during the first week. Do not make the mistake that I did and let your pain 'build up' because then it is harder to get back under control.
Personally for me, this was my medication diary (extremely simplified):
-0 days: IV morphine whilst in recovery
-0-2 days: (Hospital stay): IV diclofenac, oral co-codamol and neurofen as often as I could take it.
-3-7: Neurofen and co-codamol as often as I could take it.
-7-14: Neurofen and co-codamol around every 6 hours. It's a good idea to stagger the doses so that you're not having both at the same time, as this provides optimum pain relief.
- 14-28: Usually take neurofen and co-codamol only once in the evenings, occasionally I have to take it during the day depending on circumstances.


Will I experience numbness following jaw surgery?
During surgery many nerves that supply sensation to your face are moved around, causing you to experience numbness. Although every individual is different, the majority of the time you will experience alot of numbness following jaw surgery, especially around your lips your chin, cheeks and sometimes upto your eyes depending on your type of surgery. During surgery, your surgeons will do their best to preserve the nerves that supply sensation to your lips, chin etc... and this is the reasoning by their incisions to specific parts of your jaw. 

Will I get all feeling back following jaw surgery?
There is a 30% chance that you will experience permanent numbness to some parts of your face, including your cheeks, chin and lower lips following jaw surgery as a result of nerve damage. Feeling will start to return in the form of itching/pins and needles, however it can take upto 90 days for feeling to return.

Will I be swollen following jaw surgery?
Again everybody is different, however you will probably experience a degree of swelling following surgery that usually peaks around day 3/4. Personally for me, my swelling was not as bad as expected by me or my surgeons, so I was not given a jaw bra with ice. Swelling will gradually reduce in the upcoming weeks, however the final bits can take upto a year to fully 'subside.'
Because of swelling, your lips will also crack and flake so it is a good idea to have vaseline on hand!

Will I be bruised following jaw surgery?
Again, everybody is different. Some experience small amounts whereas others experience alot. Personally my bruising peaked around day 4/5 and got quite bad. It was yellow up my face, on my neck and on my entire chest. I also had two small black eyes instantly following surgery and a black bruising patch under my chin. I did however use arnica cream twice daily to bring out the bruising.

Will I be congested following jaw surgery? 
Most people will probably experience some type of congestion following jaw surgery due to the anaethenetist inserting a tube usually down your nose. Equally, depending on your type of surgery you could have had work done in your nasal passage. Cutting into this will increase inflammation and the production of mucus.
For me personally, maxillary impaction meant that I had to have alot of nasal work done, removing turbinates and soft tissue. On the day of surgery I had a constant runny nose that was abit gunky. However once I was sick it started to bleed, so my surgeon banded my nose to hold the blood in, which eventually crusted up and blocked my nose completely, and making me extremely congested.
I was personally advised not to blow my nose, I am currently 4 weeks post-op and am still not allowed to blow my nose due to the risk of bursting a blood vessel. To clean my nose however I extremely carefully cleaned the inside of my nose using a cotton bud and warm water; I ensured that I didn't poke around or go too deep but it did help with my congestion greatly. Other people have found neti pots to be helpful!

Will I be wired or banded?
Wiring is classed as an old method in surgeons eyes nowadays due to the risk of relapse from muscle pull, so instead use screws and plates to stablise the jaw, meaning you only need to be banded (if that!). Being banded is usually used to guide your teeth into their new position, and to condition your brain of your new bite. How long and often you wear your bands is entirely upto your surgeon; I have known individuals 2 weeks post op to be completely band free, or only have to wear their bands for a few hours a day.

Here is my band diary;
1-2 weeks: Completely banded closed for 24 hours a day.
2 weeks+: 1 band either side 24 hours a day.

What will my diet be following jaw surgery? 
I was on a strict liquid diet for the first two weeks following surgery, and have now upgraded to a soft, no-chewing diet up until my 8th week. Every surgeon is different, and each surgeon recommends different things. Usually by the 6 week mark you're safe to start chewing soft things such as pasta and rice. However It also depends on if you're wired or banded. Although wiring isn't used that much anymore, if you're banded completely closed like I was, you can't eat anything other than liquid. I am now able to eat soft foods due to the bands being reduced to only 2. People who are wired together for around 6 weeks usually have to have a full liquid diet for this period of time.

How will I care for my mouth/teeth?
You can brush your teeth as normal immediately following surgery, however surgeons advise that you use a baby toothbrush. Although it is hard to get to those back areas in your mouth, it is extremely important that you do your best to keep your mouth hygiene in best of condition as you don't want to be getting infections around your incision lines and stitches. Your surgeon will also provide you with an antiseptic based mouthwash to use 3x daily. Personally I brushed my teeth morning and night as usual, and after every meal, ensuring I used a syringe to squirt around my stitches, and to get rid of the food that had worked it's way back there (You'll be surprised where it hides!). I also swilled my mouth out with warm salty water everytime that I brushed my teeth.

3 comments:

  1. Hi Emma, I have recently had double jaw surgery and a genioplasty. I had some similar issues to you. I'm day 17 post op and still numb in areas and swollen. The main thing I'm worried about is I still can't seem to smile properly and it looks strange. My smile seems a lot smaller the before and I'm also concious that my chin appears bigger because I was used to having quite a narrow lower jaw. Did you have any of these issues? I'm hoping that it might change more as I'm healing. Thanks, Cassie
    Cassiehope.tumblr.com

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    1. Hey Cassie! Congrats on getting this far already (and Sorry for my very delayed post!). Don't worry about your smile yet, but I feel you 100%. I hated my smile for ages and I used to get really distressed about feeling like a scary clown, but it improves. Sadly we just have to give it time! (The one thing we seem to be inpatient with with the surgery). Again with the chin, even now over a year post op sometimes i'll look at pictures and think i've got a big chin - but the reality of it is that we do HAVE a bigger chin to what we're used to, so we're bound to think that. From the outside eye i'm sure it's a perfectly normal size - what I found helped me alot was to compare my now face to past pictures - I think it's so easy to forget what improvements have actually been made and that seemed to make me realise that actually the changes were for the better! Hope you're smiling more than ever! :) xxx

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  2. Hi! Please please respond! I love your blog and was wondering if it was necessary to have braces before and after the surgery if you already have straight teeth?? Let me know!:)

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