How to Reduce Swelling after Jaw Surgery

What is Swelling?

Swelling is an increase in the size or a change in the shape of an area of the body. It is caused by the accumulation of fluid in the tissues of the body. With the combination of broken bones and damaged capillaries, it is inevitable that you will experience some swelling after surgery. However, one of the most shocking issues people talk about after surgery is the level of swelling. While some patients become a little puffy cheeked, other patients swell up like bowling balls.

The first few days after surgery the sight of your face in the mirror can be quite distressing. You may even look at yourself and think “what did they do to me”? It is not uncommon to have swelling in the whole of your face and neck area. The swelling should peak by day 3 and then start to slowly decrease as you recover. You may find the swelling and pain is worse in the morning, but should improve throughout the day as you become more mobile and sit upright.

Sometimes you will wake up after surgery with a pressure bandage on your face. The bandage will feel very tight and uncomfortable. However, you will normally only be expected to wear the bandage for the first 24 hours after surgery. It has been found that the pressure bandage is very effective in preventing excessive swelling and bruising.

It would be expected that the worst of the swelling should disappear within 2 weeks. However, it can take up to 6-8 months before your tissue fluid levels return to a stable condition. In my case I had issues with the titanium plates so my swelling lasted a lot longer than most patients. Finally, it is not uncommon to experience “puffy days” after undertaking jaw surgery. Some patients, even 5 years after jaw surgery, still experience the odd “puffy day”. Just take a look at Kanye West's face from time to time. It does not last and you should have nothing to worry about.

It is vital to remain calm and not make the swelling any worse. It is essential that you do not stress your face or cry as this will cause the swelling to worsen in and around your cheek pockets.

So what can you do to reduce swelling?

There are many different techniques that you can adopt which will help to decrease your swelling. Coupled with my own experience and research, here is a comprehensive list of techniques that you can use to reduce your swelling post-surgery.

Elevation

To aid in swelling reduction you should try to sleep in a more upright position. I would recommend using 2 or more pillows. Having your head raised in relation to the rest of your body will help to drain away fluids and reduce swelling.

Light Exercise

After surgery your surgeon with advise that you do not participate in any contact sport for around 8-12 weeks. You will be able to resume non-contact sports and exercise as soon as you are ready. In mine and many other jaw surgery patients’ experiences, the first few weeks after surgery are uncomfortable and exhausting. With the pain, swelling, lack of sleep and the dramatic change in diet I was unable to do very much. It is important that you do not stay in bed too much whilst you are recovering. Many patients find that going for a short walk everyday can greatly reduce their swelling.

Plenty of Rest

It may sound so simple, but rest is one of the best ways to reduce swelling and promote healing. When the body is in a period of rest it can focus its concentration on functions that are neglected while you are awake. Sleep is a dormant period where the cells are doing a lot of repairing and your body moves from a stress response into a particle wave response. Although you may find your swelling is worse after a period of inactivity it is essential to rest in the first few weeks following surgery.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are another widely popular way to combat pain and swelling. Anti-inflammatories such as ibuprofen, diclofenac and aspirin are often given to patients after undergoing surgery. There are over 20 types of medical NSAIDs. It is important that your surgeon or health care provider is happy for you to take any medications and it is important that these medications do not interfere with any other medications you may be taking. In addition to this, if you suffer from asthma or any cardiovascular issues you may not be allowed to use any type of non-steroidal anti-inflammatory. It is always best to speak to your doctor or pharmacist before taking any form of medication, be it prescription or over the counter remedies.

Arnica 

Arnica is a homeopathic medicine. There are several species, such as Arnica Montana and A. chamissoni, which contain helenalin, a sesquiterpene lactone that is a major ingredient in anti-inflammatory preparations. It has been claimed that arnica treatment can reduce swelling dramatically, prevent muscular tenderness and ease postoperative trauma. Arnica can be purchased in many forms; gel, cream, spray, bath ointment and it can be ingested in pill form.

Although, I did not use arnica after my operation, I wish I had tried this. After my mum broke her ankle my friend bought her ionised arnica gel. Mum used the gel every day after a bath and it great reduced her swelling and bruising. She also felt that it helped to ease the pain. Please be aware that after your operation your face will be very painful and fragile so make sure that you do not rub the gel or cream in too vigorously. Also ensure that you do not get any of the gel or cream on any open external wounds.

Acupuncture 

Acupuncture has been around for many years and originates from ancient china. Most recently acupuncture has become more popular with western societies and is now available in many health care establishments as a form of pain relief and physiotherapy. It is believed that acupuncture has many benefits for patients. It is stated that it can aid in the reduction of pain, swelling and stress and also provides relief from insomnia and psychological issues; such as anxiety and phobias. The needles are very thin but long and are placed in ‘acupuncture points’ around the body. The session usually lasts for 30-45 minutes.

Read more about acupuncture in my Patient’s Guide to Acupuncture eBooklet.

Cold

Another effective way of combating swelling is by using a cold compress on the area several times a day. You can use a variety of forms, including a standard ice pack, a plastic bag full of ice or a bag of frozen peas. The cold will help to alleviate pain, inflammation, heat and redness around the swollen area.

When I returned to the ward after my operation I was given ice packs in pillow cases that the nurses wrapped around my head so the packs touched my cheeks lightly without putting too much pressure on them. I continued to use ice packs for the first 4 weeks after surgery. I used ice packs 4 times a day and kept them on for duration of 15 minutes at a time. Once my surgeon was happy for me to use heat, I started to alternate ice and heat packs to promote healing. This was both beneficial and soothing for me.

It is important that you use a covering, such as a pillow case, when using ice packs. Do not apply ice directly to your skin as it can cause ice burns and blistering.

Hot 

Hot compresses also work well in relieving facial swelling and can help to stimulate blood flow to your face, which in turn lessens the swelling and irritation. You can use a conventional heat pack that you warm in hot water or a wheat bag which you pop into the microwave. You may also like to use a heat blanket or a heated pad for a period of 15 minutes.

Please ask your surgeon before applying any heat to your face as he/she may advise against it in the early weeks following surgery. In my case, my surgeon said to use only cold compresses for the first 4 weeks after surgery.

Staying warm (in general) will also aid in recovery, as this allows oxygenated blood to flow freely throughout your body. This can help to decrease pressure in your face and relieve swelling. It can also act as an effective muscle relaxant.

Drink Plenty of Water

Another way to reduce swelling is to ensure that you drink plenty of water. Not only will this help to keep your mouth clean it will also help to keep you hydrated. By drinking more, your body will respond by getting rid of more water as well as other waste products, which can minimize swelling. Being fully hydrated, your body can remove salt which also contributes to swelling. It is recommended that you aim to drink at least 8 glasses of water a day.

Reduce Salt 

Sodium is an element that is found in many foods, as well as water. The body requires a small amount of sodium in the diet to control blood pressure and blood volume. Too much sodium may result in shortness of breath, high blood pressure and increased swelling. Reducing your salt intake can be very helpful in reducing the build-up of excess fluid in your face post-surgery. You may also want to reduce your intake of caffeinated drinks as these contain a high level of sodium.

Vitamins

Before and after surgery you may want to take a high potency multivitamin or increase the amount of nutrients in your diet (refer to the vitamin chart for ideas). If you are planning on taking supplements please ensure that they have an adequate level of vitamin B complex, magnesium, vitamin C, flavonoids, zinc and amino acid complex. Vitamin B complex and magnesium are beneficial for anxiety levels and also aids in healing. Vitamin C and Flavonoids are great for immune support and work as a great antioxidant. Furthermore, they also promote healing and have anti-inflammatory properties. Finally, zinc and amino acid complex are vital for bone and tissue formation.

Omega 3 Fish Oils

Although it is widely recommended supplement, its benefits have not yet been proven. The recommended daily amount is also unspecified. However, there is a vast amount of modern research that suggests Omega 3 oils may be beneficial in the reduction of swelling. In my case, I found that Omega Fish Oil supplements were also useful to improve the condition of my skin, hair and nails after surgery.

Spices 

If you can handle the heat, one of the alternative ways to help decrease swelling is spice. One spice frequently publicised for its anti-inflammatory properties is capsaicin, which is a naturally occurring ingredient found in chilli peppers. Other good sources include basil, bay leaves, cumin, coriander, dill, fennel, garlic, oregano, pepper, sage, and thyme.

Bromelain 

Bromelain is an enzyme found in pineapple juice. Pineapple has a long history of tradition and is used among the native people of Central and South America. Bromelain can be effective in the reduction of swelling, especially around the nose and sinus area. Numerous studies have shown that Bromelain speeds up the body's ability to heal. These studies have shown a significant difference in the speed of recovery in patients who had Bromelain before and after surgery and those patients who did not. From my own experience, I drink pineapple juice everyday as I find that it reduces the pain and pressure in my face. In general, since my surgeries, I have tried to make a more conscious effort to eat more pineapple and soft fruits. Warning: Bromelain in large amounts can increase the risk of bleeding, especially if you take blood thinners such as; clopidogrel (Plavix), warfarin (Coumadin), and aspirin.

Green Tea

If you are trying to relieve the pain and swelling in your face you might want to try drinking a lot of green tea. From my personal experience I find green tea is one of the best ways to relieve swelling and pain. Green tea has a lot of vitamins, minerals and antioxidants in it, which are great at getting rid of all types of swelling and irritation. Green tea contains salicylic acids, which is one of the main ingredients in aspirin.

When I am having a puffy day I aim to drink at least 3 cups of green tea. You may also like to drink a cup of green tea before you go to bed because it will help calm down the muscles, tissues and nerves in your face. If you do not enjoy the taste of green tea you may like to add in a teaspoon of honey. Not only does it add sweetness to the tea, it doubles up as a valuable antioxidant. Green tea can be found in most grocery stores. My favourite is Clippers Organic Green Tea.

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Always,

Steffie

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