Frequently Asked Questions
What does Orthognathic treatment involve?
The surgery commonly takes place once Orthodontic (braces, invisalign) treatment has repositioned the teeth in preparation for the surgery. In a smaller number of patients the surgery will take place either prior to Orthodontic treatment or without Orthodontic treatment at all. The planning for surgery is detailed and usually includes the production of custom surgical guides (stents) created with specialized software (based on the patient specific CT scan data) utilizing 3-D planning and printing techniques. The planning software provides vital information for procedure preparation – increases the accuracy of the procedure; reduces the risk of surgical complications; reduces the operating time; allows for minimally invasive surgery; provides the best chance of achieving optimal facial aesthetics and improved functional improvement. The procedure takes place in Hospital under a general anaesthetic (asleep); usually takes 2 – 6 hours of operating time. The operation is performed via incisions inside of the mouth (no visible scars in the skin). Patients will usually need to stay in Hospital for 2 – 3 days after surgery.
What should I expect after surgery?
You’re likely to experience some tightness over the mid to lower face, nose and neck; with discomfort and bruising around the base of the nose and cheeks extending into the upper part of the neck over the first few days; this will fade over the next two – four weeks. Ice packs (provided for you) and sleeping slightly upright for the first few days after surgery will speed the healing process. Commonly stitches in the wound will dissolve over 3 – 4 weeks after surgery.
You’ll be given scripted medications including antibiotics (to limit the risk of infection) and analgesics (pain relievers) to use at home.
Most patients can open their mouth (jaws are very rarely wired together) straight after the surgery. Mouth opening will be slightly restricted, but you will be able to talk, swallow and tolerate a soft diet.
It is important to re-establish a healthy eating pattern; a diet of easily consumed foods consisting of small amounts at regular intervals through the first few days is suggested. A pureed or semi-liquid diet (anything that can be slurped from a spoon or through a straw) is best for the first couple of days followed by soft foods that don’t need much chewing. As you feel more comfortable you can progress to more regular foods and meal times.
What does the facial trauma surgery involve?
Operations involving the trauma to the face (especially the cheek bones and eye sockets) are technically challenging; they carry a high risk of permanent complications; they take place within a very confined space. As such these procedures are best performed through the highly skilled hands of Specialist Surgeons. These procedures take place under a general anesthetic (asleep) and commonly involve the placement of small metal plates and screws to reposition and align the facial bone fractures. The aim of surgery is to restore facial form, function and appearance (simultaneously return to the pre-injury facial shape and function).
After a detailed assessment of the injuries (as guided by CT scan data and 3-D virtual models), surgery is planned to take place under general anaesthetic (asleep) in Hospital. A combination of small incisions inside the mouth, through the facial and neck skin and sometimes through the eyelids are needed to access the fractured bones to allow for re- alignment. Some fractures (eye socket fractures) will need more support in the form of bone grafts. Your Specialist Surgeon may also use titanium mesh, synthetic bone or your bone from other areas of your body to completely fix the fractures. Most patients spend one night in Hospital, to be released the next day.
Stitches used will usually dissolve completely in 3 – 4 weeks. Metal plates and screws are rarely noticeable (not visible or associated with other problems and routinely remain in place (these components are made from titanium so they won’t set off metal detectors in places such as the airport).
What should I expect during recovery from facial trauma surgery?
Initially the wounds are likely to be quite numb and hence pain-free for the first 12 – 24 hours. Swelling (and possibly bruising) will increase over the first 2 – 3 days before peaking.
You will have scripted pain relievers to use during this stage. Facial fractures rarely develop infection but you will be provided with antibiotics to further reduce the possibility.
There may be some swelling and bruising of the upper and mid face, including the eyelids; occasionally the white part of the eyes can appear red or bruised. With the use of ice packs (provided for you), compresses and maintaining an upright position in bed, swelling and bruising will fade within a couple of weeks.
Review appointments are necessary to ensure that healing progresses in an unhindered fashion. These appointments may extend over a period of 2 years; usually at 2 weeks, 3, 6, 12 and 24 months post procedure.