On Thursday, August 23, 2018, I had double jaw surgery. This included a Le Fort 3 Osteotomy on my upper jaw and a Bilateral Sagittal Split Osteotomy on my lower jaw. This corrective jaw surgery (otherwise known as orthognathic surgery) was done to fix skeletal and dental irregularities I was born with. Read on to hear about my surgery and recovery experience two weeks post operation.
Double Jaw Surgery: The Good, The Bad, and The Ugly
Wow. Writing this post has been hard to start because I don’t even know where to start. As someone who’s only surgical experience prior to jaw surgery was getting my wisdom teeth removed, I feel like I was thrown into the deep end with this one. I’ll start by saying that jaw surgery is no joke. But I really, really hope it’s worth it.
All my life I knew something was wrong with my teeth. Aside from having crooked teeth, my mouth was incredibly narrow, I had an overbite, I was a mouth breather, my teeth and gums were receding prematurely, and I would sometimes just randomly start choking on air for no reason. I figured braces would solve all my problems, but we were poor growing up and my family couldn’t afford them. So I put that wish off for one day when I was older and could afford to fix my smile myself.
One of the few times I’ve shown my bottom teeth in photos. I normally self-correct and only show my top teeth when I smile to make my smile look better.
Enter two years ago. I was 25 and employed with insurance that covers orthodontia. I googled, “best orthodontist Omaha”, set up an appointment with Dr. Igel at Igel Orthodontics (who is the best, and I 1000% recommend), and figured I was a year to two away from my dream smile.
(This is where the record scratches in my story indicating things are about to veer off my perfectly mapped out plan.)
Turns out, yes, I do need braces. It also turns out, that while my teeth could really benefit from braces, my cosmetic smile was the least of my problems.
I was referred to an oral surgeon, Dr. Desa at UNMC to discuss my jaw in more depth. (Jumping forward a little bit, but Dr. Desa is AMAZING. If you live in Omaha and can have him for your surgeon, do it. He’s the head of the entire department at one of the top hospitals in the country.) I found out that I had jaw irregularities that no amount of time in braces could cure, and as I age I’d wear out my teeth and start to suffer from more and more breathing, chewing, and potentially choking problems.
Umm, definitely wasn’t expecting to hear that!! All my life what I thought was normal biting, chewing and swallowing, was me using my mouth in ways it wasn’t supposed to be used to accomplish those tasks. And my teeth and gums showed the wear and tear as a result. Surgery could fix that, and together with braces, give me the smile I always dreamed about.
So, I got my surgery pre-approved with insurance, set up a payment plan for braces, and started my journey. I was in braces for a year and a half before I had jaw surgery. Dr. Igel had gotten my teeth as perfect as possible before I had my jaw surgery. I’m really hoping that speeds up my recovery and time in braces post-surgery.
The Day Before Surgery
As it got closer and closer to having the surgery I started getting more and more nervous. I was willingly having someone break my jaw in five places. Jaw surgery is a pretty intensive surgery and I’m a hypochondriac so my mind was finding all the things it could to stress about.
Josh took me out for a nice last meal and I tried really, really hard to enjoy it but my mind was in a million places. I was worried about not waking up from the surgery, worried about the anesthesia not working and feeling everything, worried about the pain afterward, worried about the surgery going wrong, etc. etc. I tried to get some sleep that night but I was a nervous wreck and my thoughts were all over the place. Honestly, I think the day before surgery was worse than any of my days post-surgery. The anticipation and the unknowns were terrifying.
I had to be at the hospital by 5:30 am, which I loved. If you have to have surgery and are scheduling it, always have surgery early in the morning. Science has proven this is the best time as doctors are fresh and clear-headed. There are fewer mistakes made and surgeries generally go better when conducted in the morning.
I waited in the waiting room for about 30 minutes before being called back to a pre-surgical area. I had to take a pregnancy test, change into a hospital gown, and meet with the anesthesiologist, surgeons, and nurses who would be overseeing my surgery that day.
The anesthesiologist gave me a nausea patch on my neck to ensure I wouldn’t have any problems with nausea. Because I didn’t eat or drink anything since 8 pm the night before, it was really hard for them to find a vein to start my IV. I appreciate that rather than poking and prodding, they numbed my hand and then put the IV in there.
Weirdly, once I was surrounded by all the Doctors in the hospital I started to feel really calm. They asked me what I was having done that day and I explained that Dr. Desa was breaking both of my jaws. I got to kiss Josh goodbye and then they wheeled me into the OR and had me scoot over onto the operating table. One of the Doctors told me it was time to start thinking about a happy dream.
The next thing I know I was waking up in a room with a woman screaming hysterically that she was going to die. I was so confused and didn’t know what was going on. It made me really nervous and I immediately asked to change rooms. I guess I thought I would have my own room so having to share was a bit of a bummer. That said, the nurses were great and had me moved pretty quickly into another room with a very quiet roommate.
From there I faded in and out of sleep as the anesthesia wore off. I found out I was in surgery for five hours and that everything went great. (Though they had to keep telling me this as the anesthesia made me forget everything as I went in and out of sleep). I was never nauseous, could always breathe, and my pain never went above a 4 on a scale of 1 to 10 (I’ve been told my whole life I have an incredibly high pain tolerance so that may be a part of it.).
I was freaked out because I could weirdly feel my entire face. They tell you after jaw surgery numbness is to be expected and for lower jaw surgery it’s virtually a certainty. For some reason, I woke up and could feel absolutely everything. My lips and chin felt different, but I had sensation everywhere.
My face looked like an absolute mess and I had blood and phlegm coming out of my mouth on a pretty constant basis, along with occasionally having to cough to get it out of my chest. I had a splint and was banded shut but not tightly. I mostly felt sore, swollen, out of it, and in mild pain. I asked for morphine twice during my stay in the hospital because I was scared it would get worse. (It never did.) It helped me sleep overnight, but with the nurses continually coming to check my temperature, blood pressure and to give me antibiotics and steroids to decrease swelling, sleep was very choppy.
Getting up to pee was the worst because I had an IV coming out of my arm and my foot, an oxygen tube running through my nose, and my whole monitor thing I had to wheel to the bathroom. Anesthesia makes you constipated but I probably peed five or six times while in the hospital.
Since I didn’t have my own room with a recliner or couch Josh went home to sleep overnight. My roommate was super quiet so I didn’t really know she was there other than when the nurses came in to check on us. Being in the hospital overnight is like an experience from The Twilight Zone. Time feels like it doesn’t exist and you’re in a different reality.
Day 1 Post Op
The next morning Josh came back to see me and I asked if I could have chicken broth. I was weirdly really thirsty and wanting broth. Josh fed me broth from a syringe and won all the husband brownie points. Also, it was the best chicken broth I’ve ever had.
I was tired and super out of it but feeling pretty good. While I was swollen, I was shocked at how okay I was feeling. I was able to feel and move my mouth and didn’t at all feel like my mouth was locked shut. I had expected to feel a lot worse at this point. The only way I can think to describe it is my mouth was a car and I was dealing with airbags instead of a seatbelt. I expected to be strapped together tightly and unable to move when really the only thing keeping me from moving was my puffy cheeks and lips. When the residents made their rounds to check on me I asked if I could go home that day and they said yes.
The next thing I knew I was getting ready to be discharged and I started to freak out because I hadn’t been told what to do.
Can I clean my teeth? Do I keep the bands on? When’s my follow-up appointment? My biggest gripe about my jaw surgery was the lack of communication I received. I feel like most of my pre-surgery prep and post-surgery care I had to Google to find out what I should be doing.
When I told the nurse I hadn’t been given any information she had a resident come up and answer my questions. He told me to start brushing my teeth and changing my bands the next day if possible as the most important thing is to make sure my wounds don’t get infected. This brought me a ton of stress because I had never had bands before, and my mouth, while not wired or banded tightly shut, was incredibly swollen. I could not open my mouth to fit a toothbrush in, I was so swollen I couldn’t see where my bands were, and I was so tired and weak I wouldn’t have even had the energy to change my bands. Thankfully I was also given antibiotic mouthwash. I decided to ignore the resident and use the antibiotic mouthwash exclusively until my swelling went down. This worked perfectly. I still have slight resentment that he put so much pressure on me to brush my teeth when there was no possible way a toothbrush could have gone in my mouth at that time.
After this, I was taken in a wheelchair to the parking lot where Josh had the car and drove me the ten minutes home. The ride was not bad at all. As soon as I got home I changed into PJs and a bathrobe and laid down with blankets. I wanted to make sure I could breathe and that I did not get a fever (the first and really only sign of an infection in those early days) while I slept, so I had Josh get me a forehead thermometer and oxygen monitor. They were totally worth it for the peace of mind.
Day 2 Post Op
The swelling continued to get worse. I was taking a mix of Ibuprofen and Vicodin for pain. Sleep was hard to get as I was just so uncomfortable. My jaw would clench when I slept and my head would roll uncomfortably from side to side, or up and down. I was up every two hours as I was drooling and bleeding and dealing with shooting pains under my right nostril where one of the incisions was made. I also had a low-grade fever which the Doctor was not concerned about and thankfully it went away pretty quickly. I started taking Miralax since I hadn’t pooped since before surgery at this point. I was given a prescription laxative but I read that it was super strong and overkill for a lot of people (Thankfully the Miralax kicked in and worked within 24 hours).
Days 3-4 Post Op
I’m going to be really blunt. Days 3 and 4 were absolutely miserable. I was at peak swelling, peak discomfort, and peak weakness. I had also started bruising pretty badly on my left side. I was bleeding and drooling constantly, still had the shooting pains, along with some new clicking and pulsing in my mouth, and was terrified that I hadn’t been able to change my bands or brush my teeth yet. Josh had called the medical line every night since I was released from the hospital with questions. Dr. Desa moved my appointment up two days so he could see me earlier since I was so concerned about my bands.
Josh could only drop me off at my appointment because he had to teach a class. I remember crying when he left because I felt so scared, overwhelmed, and sore. Poor Dr. Desa was probably wondering what was wrong with me!
At the appointment, they took X-Rays and had me bite for the first time. It was so hard to move my mouth I was so swollen! Thankfully they said my bite looked perfect. I got to see an X-Ray of my mouth with all the hardware in it. It was quite the site.
I explained to Dr. Desa how I hadn’t been able to brush my teeth or change my bands yet and he did not seem concerned at all. He took off my front bands and just banded me on the side in triangles so I would be able to change them easily and told me to try in a few days.
My friend Joanna was incredible and drove me home afterward. It was great to get to see her and talk a little bit, but I was pretty out of it. When I got home I climbed back onto the recliner and continued to be a vegetable.
Days 5-6 Post Op
The swelling was starting to get a bit better by this point, but my spirits were so drained. I still was getting bloody noses and having bloody spit a lot throughout the day. I was told it should abate within a week and was starting to get nervous that that wasn’t happening. I accidentally tried to blow my nose during this time and also woke up in the middle of the night propping my jaw in my left hand while I slept. Each of these incidents caused a second of pure terror, but thankfully neither did damage (I learned from Dr. Desa that if something did damage you would immediately know with either extreme pain or lots of blood).
Josh also flew to Connecticut on day six to see his mom before she had a benign tumor removed from her brain. (Note: Her surgery went perfectly and she’s healing well!) I have no family in the Midwest and didn’t feel like I could be alone at that point. My Aunt Joanie is an angel and flew in from New Jersey on day five to be with me while Josh was gone. Having her here with me meant the world.
On day five I changed my bands for the first time. It was so hard to do because my face was so swollen but I did it. I also attempted to brush my teeth with a baby toothbrush for the first time. I barely could but I did my best and then used the antibiotic mouthwash. That mouthwash was a lifesaver for me as I was so freaked out about brushing my teeth and changing my bands. It can discolor your teeth if used frequently, but Dr. Desa told me all discoloration can be fixed at a routine dental cleaning. It’s worth it to me to not get an infection.
On day six Josh flew out and my Aunt Joanie and I bummed around the house together. I went to change my bands that night and realized that the bracket on my top right side that was supposed to hold my band had broken. Are you freaking kidding me? I put the band on the broken bracket as best I could and figured that was good enough for the night.
Day 7 Post Op
I called Dr. Desa and explained what had happened to the bracket. He said I could either move both triangle bands back a tooth on each side (which was not possible because I was so swollen), or call Dr. Igel and have him fix my bracket.
So I called Dr. Igel and he fit me in that day. At first, he did not want to touch my teeth since I was so fresh out of surgery. But I explained that Dr. Desa said the band needed to go there, so he said he’d try and to brace myself because it might be painful. It’s a testament to his skill because him fixing the bracket didn’t hurt at all. He had to cut the broken one out of the wiring of the rest of my front teeth and glue a new one on its place.
Week 2 Post Op
This is where the recovery story starts to get good. Every day in week two has been better than the day before. I don’t feel like myself yet, but I feel good. The way I felt on days 3 and 4 are thankfully a distant memory.
My Aunt and I talked a lot while she was here which helped stretch my mouth muscles and get them used to moving again. She took me to Costco for my first outing for me to buy more tissues. The rate at which I go through tissue boxes is a bit ridiculous. I take them with me everywhere I go.
Josh returned home on day 9. I started eating mashed potatoes with a kid’s spoon. It feels ridiculous and was slightly painful on the roof of my mouth the first few times, but it works.
I don’t have an appetite, but have been making sure to drink Ensure, green smoothies, and milkshakes to try and get enough nutrients and fats. I’m still using a syringe which I actually really like as it makes it easy to get the food in without putting any pressure on my mouth. I’ve lost 9 pounds so far which I’m definitely not sad about.
Sleep is largely uninterrupted now, although I’m still not getting a ton of it. I feel tired but not sleepy most days so I have been laying on the couch and watching all the Netflix movies. When I do sleep I use this neck pillow which has been so helpful in keeping my head from rolling while I sleep. I hate sleeping in a recliner and am excited to be able to return to my bed soon!
I’ve been off pain meds for about five days now and feeling pretty good. Thankfully the shooting pains and throbbing and pulsing sensations are gone for now. I just have perpetual pins and needles in my chin, which is to be expected as the nerves heal.
Swelling is down a lot, although I’m still super swollen in my sinuses and chin area. I’ve heard that can take months to go away. I’ve started doing a lymphatic massage on my face to hopefully help me decongest sooner.
Really the only big annoyance I’m dealing with is the bloody mucus. Dr. Desa said that during surgery my sinuses filled with blood and fluid and that it’s going to take a while for all of that to get out of there. While I’m glad it’s nothing serious, waking up in the morning and looking down and seeing bloody drool all over your PJs is something I’d like to end sooner rather than later.
I had my two week follow up with Dr. Desa yesterday and he said I’m healing beautifully. I have an appointment with him next week to get my splint taken out and then one with Dr. Igel to get a new wire put on. I’m hoping week three will be my big turning point.
I start working from home tomorrow and am both excited and nervous. Excited because I’m hoping getting back to work will help me start to feel normal again. I’m nervous because I’m not sure how my brain will do with handling projects and emails and work tasks. I get tired so easily, but thankfully I’ll be working from my couch.
Thanks for sticking through this very long recap of my first two weeks of double jaw surgery recovery. I thought it was important to document because before surgery I was reading all the blogs I could about recovery. It brought me a lot of comfort and peace to read about others who have been through it. Know that two weeks post operation I feel good and I’m glad I had the surgery. If I can do it, you can do it too.
My recovery in photos.
Also, for anyone looking for support Facebook groups to join I highly recommend this one and this one. I just joined them a few days ago and am kicking myself for not joining them sooner. They would have totally put me at ease about the mouthwash and bloody phlegm when I was freaking out while waiting to hear back from Dr. Desa’s office. It’s also amazing to see the smile transformations people have gone through. I’m hoping I’ll have a good one of my own to share in a few months!
Questions of the Day: Have you had double jaw surgery? Was your recovery similar or totally different than mine? For those who haven’t had jaw surgery, what is the biggest surgery you’ve had done to date?