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Postoperative swelling

Question

Hello,

I would like to get information on postoperative swelling. I underwent a bimaxillary surgery (impaction + Le Fort I in the upper jaw, Epker osteotomy in the lower jaw and genioplasty) on September 9.

Today at D+11, the swelling on my cheeks and around the Epker osteotomy has pretty much disappeared. I still cannot feel my chin nor my lower lip. But mostly, the area around my nose started swelling at D+3 after I was released from the clinic, and the swelling still does not decrease…

I even feel the plates on each side of my nose. I do not have a fever and there is no oozing from my scars.

Is it normal? Will the swelling start decreasing soon? I have an appointment with my surgeon only next Thursday… Thank you!

Answer

Edema or swelling of the face after an orthognathic surgery is normal and this swelling progressively goes down. 11 days post-surgery, nearly 50% of edema should have subsided.

A recent study using a 3D stereophotogrammetric technique on postoperative swelling (JOMS2014) confirms that in average, 50% of the initial swelling has subsided after the third week post-surgery and that after 3 months, only 20% of the initial swelling remains.

This study has made a correlation between the body mass index (BMI) and edema. Indeed, patients with a high BMI have more post-operative edema, but their edema has the highest reduction rate during the first week.

Comparatively, patients with a lower BMI have less postoperative edema, but it takes more time for this edema to resorb. They have not found a different between men and women on the initial edema or the resorption of the edema.

It is normal for you to feel the plates on each side of your nose. This sensation should decrease with time. From what I can remember, I have had one or two patients whose plates were too prominent and they had to have them removed 6 months after the surgery.

The sensitivity in the chin can take from 2 to 3 months before going back to normal. Sometimes, it can take 3 to 6 months. Beyond 6 months, chances are that the loss of sensitivity is permanent.

van der Vlis M, Dentino KM, Vervloet B, Padwa BL., Postoperative swelling after orthognathic surgery: a prospective volumetric analysis. J Oral Maxillofac Surg. 2014 Nov;72(11):2241-7. doi: 10.1016/j.joms.2014.04.026. Epub 2014 May 2.



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