Surgery and the post-operative period

S'OS > Services > Orthognathic surgery > Surgery and the post-operative period

(ORTO-4)

The following tests must be carried out one week before the surgery:

  1. Essential blood test
  2. Bleeding and coagulation time, SPA, INR, APTT
  3. Blood group and Rhesus factor
  4. Biochemical blood test (K, Na, Ca, urea, creatinine, fibrinogen, AST, ALT)
  5. Electrocardiogram with description
  6. Urine test
  7. A chest radiograph (if it was not taken in recent years)

Results of tests must be brought to consultation with a surgeon before the surgery and to examination with doctor anesthesiologist.

Things to know before the surgery:

  • Orthognathic surgery is a planned procedure; therefore, the patient must be completely healthy and not sick with viral respiratory infections for 2-3 weeks before the surgery. If the patient catches a cold or gets a running nose before the surgery, then it will be postponed for 2-3 weeks.
  • The stomach must be empty before the surgery. If the surgery is planned to be carried out early in the morning, the last food intake should be before 8 PM on a day before the surgery; liquids can be consumed until 10 PM.
  • Eating and drinking in the morning before the surgery is strictly forbidden. It is a critically important rule – if the contents of the stomach get into the respiratory tract, it could lead to a fatal outcome.

The course of the orthognathic surgery:

  • The mandible is divided lengthwise into two lateral parts and a central part which contains teeth. The central part is moved into the desired position and attached to the parts remaining in the initial position by using titanium plates and screws.
  • The maxilla gets uncovered, separated, and, if need be, split into 3 or 4 parts. Then it is fixated with titanium plates that are sutured over with mucosa and remain there indefinitely.
  • Once the fixation of the maxilla is complete, small bits of bone are collected from chin and cheekbones to fill in the gaps in the jaw cutting areas.
  • Chin surgery or mentoplasty can be performed additionally. During the surgery, the chin part of the mandible is cut, moved forward, and fixated in a new position with plates and screws.
  • All wounds are sutured.

Post-operative period

After surgery performed on one jaw, the patients are treated in hospital for 1-2 days, after the operation of two jaws, they are treated for 2-3 days. On average, it takes ten days for the wounds to heal. The mandible heals up in 2 months, and the maxilla heals in 4 months on average.