What to expect:
o Avoid vigorous activity for a full week. You should go on multiple walks every day.
o Use ice packs or bags of frozen peas during the first 24-48 hours. 30 minutes on and 30 minutes off.
o You may still have some clicking or grinding noises in the TMJ.
o Some people have a fullness in their ear or a muffled sensation; this is due to the swelling and gets better as the swelling goes down.
o Sometimes the numbing medicine and the swelling can make it seem like it’s hard to raise your eyebrow.
o It takes about 7 days for the Botox to have an effect on the muscles. It usually lasts about 3 months.
Follow Up Appointments:
o We generally have a 2 week, 1 month, and 3 month follow up after surgery.
Diet:
o Eat a non-chew, pureed diet for 2 weeks after surgery. After two weeks you can resume mushy soft foods.
o Things like Boost & Ensure are an excellent source of the protein, fats, and carbohydrates that you need to heal.
o DO NOT eat tough, chewy foods and foods like bread that require a lot of force to tear with your teeth.
o If you have a lot of nausea and vomiting, then focus on clear liquids and maintaining hydration. If the nausea and upset stomach is persistent, please contact our office. We will prescribe an anti-nausea medication.
Bleeding:
o The small puncture holes from the needles might have a little oozing for 24 hours.
o If there is persistent bright red bleeding, then please contact our office.
Pain Management:
o Some discomfort is expected during the first several days. The goal is to minimize the discomfort so that it is tolerable. It is unrealistic to expect zero pain after surgery, but we will work with you to minimize the discomfort as much as possible.
o Very few people actually need to take a narcotic pain medicine. Narcotics have real risks and side effects such as nausea and vomiting, constipation, drowsiness and addiction. However, if there is severe pain that is not well controlled with ibuprofen and Tylenol, then we can prescribe a small amount of prescription pain medication. Take the narcotic pain medication exactly as prescribed to avoid a complication.
o Use ice packs the first day, 30 minutes on and 30 minutes off.
o Apply warm moist heat with a compress five times a day for 2 weeks after surgery.
Swelling:
o Swelling is normal after surgery. It is normal for swelling to increase for the first 2-3 days after surgery.
o For the first 24 hours, you should wear the head wrap.
o You can keep your head slightly elevated when you sleep. Spending more time sitting upright and on your feet, rather than lying flat will help reduce the swelling. If you sleep all night on one side of your face, it will be more swollen the following day, but should even out during the day when you are upright.
o Sometimes there is bruising that can take weeks to resolve.
Wound Care:
o Simply apply a small amount of antibiotic ointment twice a day for 3 days. Keep the area clean. 24 hours after surgery it is ok for soap and water to run over the site. Pat it dry.
Activity:
o I recommend you take 2-3 days off from school/work.
o You should not drive a car, operate machinery or sign legal documents if you are taking narcotic pain medication.
Sutures:
o Resorbable sutures usually last 7-14 days. Non-resorbable sutures will be removed 5-7 days after surgery.
Antibiotics:
o Take the prescribed antibiotics as instructed. If you develop a rash or other side effect, stop the antibiotic and contact our office.
Medications:
o You should have the following medications:
o Anti-inflammatory: either Naprosyn or Ibuprofen
o Muscle Relaxant: Robaxin, Zanaflex, or Flexeril are commonly prescribed
o Antibiotic: usually Keflex (if no allergies) for 2 days.