Instructions Following Jaw/Facial Fractures

1. Swelling
This is quite a normal response and usually reaches its peak 24-30 hours following surgery. It often varies from one side of the face to another depending on the degree of difficulty. The swelling will start to decrease after 4-5 days.

2. Bruising
Bruising may occur as the swelling starts to subside and is again not unusual.

3. Bleeding
Bleeding may occur after jaw surgery and responds well to direct pressure. If it occurs, use a clean rolled handkerchief to apply direct firm pressure to the bleeding site for one hour. If bleeding persists, please contact the surgeon.

4. Discomfort
Always occurs with varying intensity. Initially, it is important to take the painkillers regularly. This should decrease significantly after 2-3 days with a decrease in the need for painkillers. This is normal and will pass as the swelling subsides. Sometimes sharp wires may stick into the cheeks or gum and it may be necessary for the surgeon to tuck them in but in the event they become very irritating, you may apply some orthodontic wax or similar until you can see the surgeon.

5. Nausea
Nausea and/or vomiting following jaw surgery is common and may relate to the anaesthetic, medications or swallowed blood. It is wise to have clear fluids only for the first 24 hours. Medications to prevent nausea/vomiting will be prescribed for you while you are in hospital and you should request these as necessary.

6. Infection
Infection is uncommon following jaw surgery and if it does occur, it will show itself by a late increase (3-4 days) in swelling and/or discomfort and/or the onset of a discharge. In most cases, antibiotics will have already been prescribed postoperatively to prevent infection. It is important to finish the course even if there are no problems.

7. Stitches
Dissolving stitches will be used in almost all cases. They will fall out or dissolve in approximately 7-14 days following surgery.

8. Oral Hygiene
DO NOT RINSE YOUR MOUTH UNTIL THE NEXT DAY AFTER SURGERY. Rinsing in the early stages will cause bleeding. Rinsing with a mouthwash is suggested (eg a teaspoon of salt in a glass of warm water or Savacol twice a day for 2 minutes each time) as this will also help keep the mouth clean. Tooth brushing should be recommenced as soon as possible and can be applied with toothpaste to the outside of the teeth, wires and splint if present. This should be done after any food or fluid intake.

9. Lips
It is advisable to keep the lips moist by frequently applying a lip balm, lanolin, Vaseline, etc to the lips.

10. Talking
Soft tissue swelling may create difficulties with speech. Talking is possible but can be challenging. You will need to speak very slowly, making full use of your lips and tongue.

11. Jaw Stiffness
Following a jaw surgery there may be limitation in mouth opening. Normal opening of your mouth will gradually return but will need constant exercising during this recovery period.

12. Diet
Good nutrition is essential for bone healing and unfortunately your diet will be restricted to soft foods and fluids initially. A gradual return to a normal diet is recommended. Either a dietician will advise you as to the variety of foods that may be taken or your surgeon will supply a diet sheet. A blender or vitamiser will help with the preparation of a liquid / soft diet initially. Fluids may be taken in with a straw, syringe or squeeze bottle.

13. Weight Loss
A moderate loss of weight (4-6kg) is not unusual in the first few weeks following surgery. This weight loss will plateau with appetite returns and more meals are tolerated. It is advisable to have frequent meals spread throughout the day rather than the routine three meals a day.

14. Elastics
Orthodontic elastics may sometimes be placed between the top and bottom teeth in the few weeks following surgery. This is done to train the jaws to close in the correct position as well as helping the bones heal in the correct position. The elastics can be removed and replaced by you at any time for your convenience (eg meal times, tooth brushing etc.) and you surgeon will show you the correct placement of the elastics.

15. Drains
Drains may be secured to the operative sites to help reduce swelling and usually will be removed the day after surgery.

16. Smoking
It is advisable that you refrain from smoking for at least 3 days after the surgery as this increases the risk of infection.

17. Review
Following your discharge from hospital, it will be necessary to attend review appointments at the rooms to monitor progress and answer any general queries you may have The reviews will be more frequent in the early phase following surgery.

18. Problems
If problems arise contact your surgeon on:
Dr Brian McMillan / Dr Sunia Vudiniabola Pager: (03) 9625 1201 (please leave message & phone no.)