The following tests must be carried out one week before the surgery:
- Essential blood test
- Bleeding and coagulation time, SPA, INR, APTT
- Blood group and Rhesus factor
- Biochemical blood test (K, Na, Ca, urea, creatinine, fibrinogen, AST, ALT)
- Electrocardiogram with description
- Urine test
- 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.
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.