Orthognathic Surgery Recovery: A Patient’s Guide

Orthognathic surgery is corrective jaw surgery designed to fix misaligned jaws and severe bite issues, known as malocclusion. This complex procedure addresses structural problems or skeletal discrepancies that braces alone simply can’t correct. It’s designed to improve both function and your overall quality of life. Think of it as the foundation work that allows everything else to fall into place.

Naturally, the thought of having jaw surgery may come with many questions and concerns. But the good news is that this surgery has an impressive success rate of around 93.9%, according to a study published in the International Journal of Oral & Maxillofacial Surgery. The majority of patients studied reported improvements in facial and teeth appearance, biting, chewing and general eating function.

This guide will walk you through what to expect during your orthognathic surgery recovery time, from the first few days to the months ahead.

Understanding orthognathic surgery and the recovery timeline

We’ll start with the basics. There are different types of jaw surgery, depending on which part needs correcting:

• Upper jaw surgery (maxillary osteotomy) repositions the top jaw.
• Lower jaw or bottom jaw surgery (mandibular osteotomy) corrects the bottom jaw position.
• Double jaw surgery (bimaxillary osteotomy) addresses both upper and lower jaws simultaneously.

What’s the general recovery timeframe?

The overall treatment is a long-term process, typically lasting two to three years, combining the surgery itself with orthodontic treatment before and after. So when we talk about recovery time in the UK, we’re really looking at layers of healing:

• The initial intensive healing takes about six to eight weeks.
• Full bone strengthening occurs over several months, sometimes up to a year.
• The time needed off work or study for most UK patients is generally two to four weeks, though six weeks might be recommended for those doing physical labour.

It’s worth noting that orthognathic surgery is major, requiring general anaesthesia. This isn’t minor orthodontic surgery – it’s a significant procedure that requires proper planning and recovery time.

Preparing for recovery: essential pre-operative steps

Preparation is absolutely key for a successful recovery. Your journey begins with a comprehensive consultation with your orthodontist and oral surgeon, who’ll map out exactly what to expect.

Your pre-surgery checklist

Diet planning: Stock up on liquid foods, soups and smoothies. You’ll be on this diet for about a month, so variety is your friend.

Medication: It’s advisable to get all prescribed antibiotics and pain medicine filled in advance. The last thing you’ll want after surgery is a trip to the pharmacy.

Support system: Line up friends or family who can help during the immediate post-operative phase. You’ll need someone to drive you home and support you through those first few days.

Pre-surgical orthodontic treatment: Your teeth will be aligned in preparation for the jaw move. This groundwork is crucial for achieving the best possible result.

Initial post-operative care: the first two weeks

This is the most demanding time in the orthognathic surgery healing stages. Here’s what you can expect.

The hospital stay and immediate recovery

You’ll typically stay in the hospital for one to three days. Most patients report feeling discomfort rather than sharp pain, which is reassuring. Your medical team will monitor you closely and ensure you’re comfortable before discharge.

Jaw swelling and bruising

Jaw swelling and bruise marks are completely normal. Swelling usually peaks around days three to five, then gradually improves. Here are some recovery tips for managing facial swelling:

1. Elevate your head using pillows when lying down.
2. Use cold ice packs on the facial area during the first 24 hours.
3. Be patient – it will improve day by day.

Some patients in hospital may receive a Hilotherm cooling mask, which helps reduce the swelling through controlled cooling therapy.

Sensation and numbness

Numbness in the lips, chin and mouth is common after jaw surgery. This usually improves gradually, though for a small number of patients, sensation in the bottom jaw lip may persist longer. Don’t panic if this happens, as your surgeon will monitor your progress closely.

Stitches and appliances

The sutures or stitches inside your mouth are typically dissolvable and will disappear after about 10 days to two weeks following surgery. You won’t need to have them removed.

You’re likely to wear elastics between your teeth and a brace to guide the alignment. In severe cases, the surgery may be secured with plates and screws, though jaws are rarely wired together nowadays, as that’s old-school thinking.

Bleeding and side effects

A small amount of bleeding or oozing is normal on the first day after surgery. If you had upper jaw surgery, some blood may come from your nasal area. Use gauze gently if needed, but if bleeding persists or becomes heavy, contact your surgical team.

Pain relief matters

Take your pain medicine (such as paracetamol or ibuprofen) exactly as prescribed. There’s no prize for being stoic. Let your oral team know if pain doesn’t subside or worsens, as this could indicate something that needs attention.

Meticulous post-surgery care: diet and hygiene

Your recovery depends heavily on following dietary and hygiene guidelines carefully. Think of this as the boring but essential part that makes everything else possible.

Diet progression over six weeks

Stick strictly to a soft diet for six weeks. If you’re having bimaxillary surgery (on both upper and lower jaw), you may need to extend this guideline to as long as 12 weeks. Here’s how it typically progresses:

• Week one: Liquid foods only – soups, smoothies, protein shakes, yoghurt.
• Week two onwards: Gradually introduce foods that don’t require much chewing – mashed potato, scrambled eggs, porridge.
• Weeks four to six: Eat soft foods that can be broken down easily with minimal jaw movement. 

Avoid hard, crunchy foods completely during this six-week period. One moment of weakness with a crispy roll could set your recovery back significantly.

Hydration is non-negotiable

Drink a minimum of two litres of fluids daily, especially water. Staying hydrated helps your body heal and prevents complications.

Oral hygiene: patience is required

Oral hygiene is vital to avoid infection, but you'll need patience for proper oral hygiene around your healing mouth.

Tooth brushing: Use a small-headed toothbrush and begin tooth brushing gently. Take your time and be thorough but gentle around the incision sites.

Rinsing routine: Avoid rinsing your mouth immediately after surgery. The day after surgery, begin using a prescribed mouthwash and warm salt water mouth rinses. Make the rinse using a teaspoon of salt in a glass of warm water and perform this several times a day. Use a syringe to help rinse your mouth and reach difficult areas around your gum line.

Lip care: Keep your lips moistened with a lip balm or petroleum jelly. Your lips will feel dry and possibly stretched, so regular application helps prevent cracking.

Medication: If you’re prescribed an antibiotic, ensure you finish the entire course, even if you’re feeling better. This prevents infection and resistance. Research published in the Journal of Cranio-Maxillo-Facial Surgery shows that extended postoperative antibiotics can reduce surgical site infection risk by up to 82% following jaw surgery.

Returning to normal: activity, work and movement

Rest and recovery pace

Rest is essential in the initial days. Your body is working hard to heal, so don’t fight it.

Work and study

You should take around three weeks off work as a general guideline, though some patients need the full four weeks, depending on their job and recovery progress. If your work involves physical labour or lots of talking, err on the side of taking more time.

Exercise and physical activity

Start with gentle activity, like a walk in the fresh air after the first week. Fresh air and gentle movement are good for your mental wellbeing, too.

Avoid strenuous activity and contact sports for six weeks to two months. Your jaw needs time to heal fully before you put it under any stress.

Tips for faster jaw surgery healing

You can accelerate healing by following diet, hygiene and medication advice consistently. Note that you must avoid smoking or vaping. Smoking significantly impairs wound healing and increases the risk of infection. If there’s ever a time to quit, this is it.

Jaw exercises for normal function

Around 10 days (or one to two weeks) after surgery, your surgeon may advise gently opening and closing your mouth to regain normal function and movement. This includes forward and backward motion, plus side-to-side movement. Start slowly and don’t push through pain.

The long-term partnership: orthodontic follow-up and emotional wellbeing

Follow-up care

Regular check-ups with your orthodontist and oral and maxillofacial team are critical to monitor progress. Your braces will usually remain for six to nine months post-surgery for fine-tuning the bite. After the brace is removed, you’ll wear a retainer to maintain your results. Don’t skip this step.

Our collaborative care approach

We believe in a collaborative approach at Hampstead Orthodontic Practice. If you’ve been referred to us for jaw surgery, we keep your general dentist fully informed of your progress and only perform the agreed treatment. Once active treatment is complete, patients return to their regular dentist for long-term care, but you’re always encouraged to re-self-refer if concerns persist.

Your emotional outlook matters

Recovery over several weeks can be taxing, so feeling a bit low or frustrated is completely common. Try to maintain a positive mental attitude by remembering why you’re doing this. The procedure is designed to improve function and your facial appearance significantly.

Viewing orthognathic surgery ‘before and after’ images can be highly motivational when you’re in the thick of recovery. These transformations aren’t just cosmetic – they represent improved breathing, eating, speaking and overall quality of life.

When to contact your specialist

Ensure you follow all post-operative instructions given by your surgeon. These are tailored to your specific procedure and situation.

Don’t hesitate to contact us, or your specialist, urgently if you experience:

• A fever
• Pain that worsens instead of improves
• Signs of infection (increased redness, warmth, pus)
• Persistent bleeding that doesn’t stop with gentle pressure
• Shortness of breath

Your next steps

Orthognathic surgery is a major step, but it delivers life-changing results for bite correction and facial balance. The recovery period requires commitment, but the payoff – improved function, confidence, and wellbeing – makes it worthwhile.

Whether you’ve been referred or are exploring the treatment yourself, Hampstead Orthodontic Practice provides the collaborative specialist care necessary to support every stage of jaw surgery recovery. We’re here to answer your questions and guide you through the process.

Ready to discuss your specific needs? Book a FREE orthodontic consultation with us today to chat about what orthognathic surgery could mean for you.

FAQs

How long does orthognathic surgery recovery take in the UK? 

Initial intensive healing takes about six to eight weeks, with most patients needing two to three weeks off work. However, full bone strengthening and tissue regeneration may take several months or up to a year.

How can I reduce jaw surgery swelling? 

Elevate your head with pillows when lying down, use cold ice packs on your face during the first 24 hours and be patient. Swelling typically peaks around days three to five, then gradually improves.

What can I eat after orthognathic surgery? 

You’ll need to follow a strict soft diet for six weeks. Those having bimaxillary surgery may need to do so for eight to 12 weeks. Start with liquid foods like soups and smoothies for the first week, then gradually introduce soft foods that don’t require much chewing, such as mashed potatoes and scrambled eggs.

Is numbness normal after jaw surgery? 

Yes, numbness in the lips, chin and mouth is common after orthognathic surgery. This usually improves gradually, though for a small number of patients, sensation may take longer to return.

When can I return to exercise after jaw surgery? 

Start with gentle activities like walking after the first week. However, you should avoid strenuous activity and contact sports for six weeks to two months to allow your jaw to heal fully.