1. Go to your nearest emergency room if you are having trouble breathing.
  2. Notify our office if you have increasing drainage from your incision or recurring fever (>101.5 F) for more than 12 hours.
  3. Facial swelling will increase for the first 48–72 hours. Apply ice packs (20 minutes on/20 minutes off) and keep your head elevated (extra pillow or recliner). Most of the swelling will resolve within the first few weeks; however, healing will continue for 4–6 months.
  4. Bruising may occur after a few days. In some cases, the bruising may extend onto your upper chest.
  5. You may shower, but try to keep the bandages dry. A small band-aid may be applied if they come off.
  6. No smoking.
  7. Avoid alcoholic beverages.
  8. Brush the teeth gently with a child size soft bristle brush. You may use toothpaste. Your gums will have reduced sensation. Be careful not to injure the gums while brushing.
  9. You may use a mouth rinse.
  10. If the teeth are rubber banded together, please try to limit your jaw motion. The rubber bands may be cut with scissors in case of a true breathing emergency (notify the doctor afterward).
  11. If you are given an antibiotic, it should be taken as directed for 5 days. The first dose may be taken when you arrive at home.
  12. The liquid pain medication can be taken every 4–6 hours as needed.
  13. While the teeth are rubber banded, meals may include liquids such as juice, broth, milk products (including soy, rice), and liquid supplements (instant breakfast, Boost®, Ensure®). No chewing. Your doctor will advise you when it is safe to begin chewing. Most large pharmacies carry a variety of supplements in different flavors. It is generally easier to sip directly from a cup, but you may use a straw if you like. You should try to have 4–6 meals a day to be sure that you are receiving ample nutrition and hydration.
  14. Do not lie in bed all day. This can lead to pneumonia and blood clots. Light activity is acceptable, even good. Try to be out of bed during the daytime.
  15. You should not drive if you are taking pain medication.
  16. Please notify your doctor if you feel that your bite has shifted.
  17. Drs. Kupferman, Walline, Relle, Lee, and Sonnichsen may be reached 24 hours a day at (310) 842-4811 if there are any questions or concerns.

In addition to the above, for upper jaw surgery patients:

  1. Nasal congestion and minor nosebleed are expected. You may sniff back or wipe the nose, but do not blow. You may use saline nasal spray to loosen clots and mucus. Afrin® Nasal Spray may be used for severe congestion, but no more than two consecutive days.

Post Surgical Aftercare – Follow-Up After Surgery

  • We understand that the first week after surgery can be difficult. Although the swelling peaks at 2-3 days after surgery it doesn’t really start to come down until after the first week. At 2 weeks after surgery, usually 70% of the swelling has resolved. For the final swelling and numbness to resolve it will take weeks to months after surgery. It is not unusual to be more swollen or numb on one side vs. the other.
  • One week after surgery you will follow up with Drs. Kupferman, Walline, Relle, Lee and/or Sonnichsen. If you need to be seen sooner it will not be a problem. At one week the swelling should be starting to come down. You should still be on a liquid diet at this point. Your doctor will change out your rubber bands and answer any questions you may have.
  • At two weeks after surgery, you will begin to take off and put on the rubber bands yourself. We will show you where we want the rubber bands to go. See the chart below. The doctor may change the pattern of your rubber bands over the next 8 weeks.

You will take the rubber bands off for three reasons:

  1. Eating – Your diet can advance to very soft foods such as mashed potatoes and very soft pastas. No chewing. You can have anything you want but no chewing.
  2. Mouth opening exercises – With the rubber bands off you will now begin to stretch the mouth open. You will need to do this 6 times a day for a period of 5-10 minutes. We do not want you to hurt yourself. Stretch the jaw open so you can regain your normal mouth opening.
  3. Brushing teeth – After your meals and mouth opening exercises you should thoroughly brush and clean your teeth. If you have a splint on the upper jaw, do the best you can. We understand that this can be difficult.


In rare cases, a splint is left in after surgery. If this is the case, your doctor will remove it 1–2 weeks after surgery.

6 weeks

You can blow your nose 6 weeks after surgery. We will again assess your bite and change the elastic pattern if needed.

8 weeks

You may begin chewing food 8 weeks after surgery. Start with softer foods, and over the next 4 weeks, you can transition to a normal diet. If you still have rubber bands, you will likely only need to wear them at night time now.

12 weeks

You will need to be seen 12 weeks after surgery and then every 3 months until your braces are off. After your braces come off, you will need to come into the office for final records.

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