Corrective jaw surgery, also known as orthognathic surgery, offers numerous benefits for individuals experiencing TMJ pain, sleep apnea, and other conditions. Experienced oral surgeons are properly trained to perform this complex procedure. A crucial aspect of the healing process is adhering to a specific diet to facilitate proper recovery. This article provides a detailed guide to the orthognathic surgery recovery diet, including food choices, preparation methods, and essential tips for maintaining your weight and ensuring optimal healing.
Introduction
Following corrective jaw surgery, adjusting your meals and snacks as your bones and facial structures heal is essential. The initial healing stage requires consuming mostly liquids and pureed foods. As the recovery process progresses, you can gradually introduce soft foods and eventually resume chewing. This article provides the information to assist you in the selection and preparation of a nutritiously blended diet which will help you heal and maintain your weight and energy.
Initial Recovery Stage: Liquids and Pureed Foods
Swelling and numbness from anesthesia are expected immediately following your procedure, making eating and drinking difficult. During this stage, your diet should consist primarily of liquids and pureed foods. Avoid chewing, as your bones are stabilized only by the plates and screws inserted during surgery.
Recommended Foods
- Smoothies and Shakes: Fruit- or yogurt-based drinks are excellent options.
- Dietary Supplements: Ensure and Sustacal can help maintain a healthy weight during recovery.
- Protein and Milk Powders: These can be added to smoothies to increase caloric intake.
- Thick Purees: As you heal, thick purees will become a more substantial part of your diet.
Transition Stage: Introducing Soft Foods
As the recovery process progresses, you may begin to introduce soft foods that require minimal chewing. The goal during this stage is to increase menu offerings while limiting the strain caused by traditional amounts of chewing.
Recommended Foods
- Soft-Cooked Meats: Chicken, fish, and hamburger can be consumed in small amounts.
- Mashed Vegetables: Potatoes, carrots, and squash are good options.
- Soft Fruits: Bananas, peaches, and pears can be easily mashed or pureed.
It is important to avoid putting too much force on the bones, which are still healing. Jaw muscles will tire quickly and begin to strengthen as you continue consuming solid foods.
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Blending Techniques and Guidelines
Ideally, patients use a blender (stationary or handheld) or food processor. Otherwise, commercial baby food may be used. During the first few weeks of your recovery period, your diet will consist of fluids and foods that are thinned and run through a blender. The addition of minced or finely chopped foods into your diet varies with the type of surgery performed; check with our office before you increase the texture of your diet. As a general rule, jaw surgery patients should not use a straw during the recovery period, unless cleared by your surgeon.
General Blending Guidelines
- Consistency: Food should be blended with enough liquid to produce a thin, easily swallowed meal. When the jaws are wired together tightly, it may be necessary to strain the blended food.
- Flavor: To add flavor and interest to blended foods or commercial baby food, it may be seasoned with butter or margarine and warmed to your liking.
Blender Method
- Place liquid in a blender.
- Add food.
- Blend on low until smooth.
- Add additional liquid or increase the blender speed to reach the desired consistency.
Sorting Blended Foods
Prepare more than one serving at a time and store in the refrigerator in a closed container for two or three days, or in the freezer in individual portions labeled and dated. To serve: Defrost in the refrigerator or over hot water and heat only the amount you need for one meal.
Specific Blending Instructions
- Blending Fruit: Use 125 ml (1/2 cup) chopped, cooked, or canned fruit blended with 15-30 ml (1-2 tbs.) unsweetened fruit juice, ice cream, or pudding. Use lemon juice or orange juice with fresh peaches or bananas to keep them from turning brown. Note: Certain fruit, such as cherries and pineapple, cannot be pureed well.
- Blending Vegetables: Use 125 ml (1/2 cup) well-chopped cooked or canned vegetables blended with 30-45 ml (2 or 3 tbs.) cream sauce or vegetable cooking water. Note: Cabbage and celery cannot be blended well.
- Blending Meat: Use 125 ml (1/2 cup) tender cooked cubed meat, fish, or poultry (not fried) blended with 45-60 ml (3 or 4 tbs.) gravy or cream soup, or vegetable cooking water or vegetable juice. Note: 1 serving of meat, fish, or poultry is 90-125 ml (6-8 tbs.) pureed.
Meat Alternatives and Combination Dishes
- Cooked or canned legumes (baked beans, kidney beans, chickpeas, etc.) and lentils can be blended following the instructions for vegetables.
- Cottage cheese can be combined with milk or soft fruit and blended to the desired consistency.
- Scrambled eggs, or scrambled eggs with grated cheese, may be combined with milk and blended to the desired consistency.
- Spaghetti with meat sauce, macaroni and cheese, chili con carne, etc. may be pureed following the instructions for meat.
Food Choices and Nutritional Guidelines
A variety of nutrients are needed to help you heal and maintain good health. Follow the guidelines of the United States Department of Agriculture to assist you in consuming a nutritionally well-balanced diet. Choose lower-fat foods more often and enjoy a variety of foods from each group every day. The Food Guide recommendations include lower and higher number of servings for each food group because the amount of food you need every day from the food groups depends on your age, body size, activity level, and whether you are male or female.
Recommended Daily Servings
- Milk Products: 3 to 4 servings daily. 1 serving is any of the following: 250 ml (1 cup) of whole, 2% or chocolate milk, or milk-based drink (milkshake) or cream soup made with milk; 175 ml (3/4 cup) of yogurt, ice cream, milk pudding, or cottage cheese blended with milk. Note: If you can’t tolerate dairy, please refer to the helpful tips section.
- Meats and Alternatives: 2 to 3 servings daily. 1 serving is any of the following: 50-100 g (2-3 oz.) of cooked tender meats, fish, or poultry; blend meats with cream, sauce, creamed soup, or hot broth or gravy; 1 small jar (100 g) of baby food meat thinned with gravy or soup; 1-2 eggs, scrambled and blended with milk, or added to soup (such as egg drop soup); 125 ml (1/2 cup) of cooked beans, peas, or lentils (blended with liquid); 75 ml (1/3 cup) tofu blended into soup; 2 tbs. peanut butter (blended into drinks).
- Grains: 5 to 12 servings daily. 1 serving is any of the following: 126 ml (1/2 cup) of hot cereal (cream of wheat, oat bran, or strained oatmeal) thinned with milk; 125 ml (1/2 cup) of infant cereal mixed with juice or milk; 125 ml (1/2 cup) of cooked rice or noodles blended with soup or milk.
- Fruits and Vegetables: 5 to 10 servings daily. 1 serving is any of the following: 125 ml (1/2 cup) of cooked or canned fruit blended with fruit juice, ice cream or pudding; 125 ml (1/2 cup) of well-cooked vegetables blended with broth, sauce or cream soup; 125 (1/2 cup) of fruit or vegetable juice; 1 small jar (128 g) of baby food vegetables thinned with margarine or sauce; 1 small jar (128 g) of baby food fruit thinned with juice.
Maintaining Your Weight
It is important that you maintain your weight during the recovery period (Tip: Aim to weigh yourself once a week). Losing weight indicates that you are not consuming enough calories, and this can delay your healing. To increase your caloric intake, you can:
- Increase the number of meals and snacks you eat
- Use whole milk or use a combination of half cream and half milk in recipes for puddings and milkshakes
- Add skim milk powder (4 tbs.) to each cup of milk used for soups, milk drinks, and puddings
- Add extra fat (butter, margarine, oil) and eat high fat (but healthy) food
- Don’t fill up on low-calorie fluids such as coffee, tea, broth, diet soda, or water - save these fluids for the end of the meal.
The Importance of Fiber
To help prevent constipation, add extra fiber to your diet by:
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- Mixing 1 or 2 tbs. natural bran or wheat germ with hot cereals, casseroles, soups or milk drinks
- Eating high fiber legume dishes such as blended, baked beans or split pea soup
- Having blended prunes or prune juice once a day
Note: DO NOT make all of these changes on the same day. Fiber should be gradually increased throughout a few days.
Nutritional Supplements
Nutritional Supplements provide liquid nutrition in a convenient form. These products are not essential but can be helpful as part of a meal or snack. Also, if you find it difficult to consume the recommended servings from the grain products or milk products groups, you could include 1 or 2 servings of a nutrition supplement since it is a good source of the nutrients provided by these groups. Some products to look for at your drug store or grocery store:
- Boost*
- Carnation Instant Breakfast
- Ensure, Ensure Plus Essentials*
- NuBasics, NuBasics Plus
- Resource, Resource Plus, Resource for Kids
- Pediasure* (for children)
Note: *These items are lactose-free. Vitamin and mineral supplements are not necessary with a well-balanced diet. However, if you find that you are not able to regularly consume the recommended number of servings from the United States Department of Agriculture, it would be beneficial to take a vitamin and mineral supplement. Ask your pharmacist to help you choose a suitable variety, since you may need this supplement in liquid form.
Helpful Tips
- Lactose Intolerance: If you can’t tolerate lactose or are allergic to dairy, try the following: Use Lactaid milk (if you are lactose intolerant) or soy milk (if you are allergic to dairy); Use a lactose-free nutritional supplement (they may not be milk-free) as part of a meal or snack; Use a soy-based frozen dessert such as Tofutti in place of ice cream in beverage recipes.
- The Rule of Twos: Remember the Rule of Twos: 2000 calories a day; 2 liters of liquid a day; 2 weeks of no nose blowing (upper jaw surgery only).
- Dehydration: Significant dehydration can occur over 1-2 days. Drinking should be strictly enforced by the caregiver, whether or not the patient desires to drink. The only alternative is to place an intravenous line (IV) to replace lost fluids.
- Balanced Nutrition: All patients benefit from proper nutrition which includes proteins, carbohydrates and fats (yes, even fats!).
- Supplements: Supplements, such as Ensure, Boost, Powerade, and Gatorade add calories and help the healing process.
- Creativity: Be CREATIVE!!
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