Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, and blood thinners 10–14 days before. Stop fish oil, vitamin E, ginseng, ginkgo. Smoking and vaping must stop 6 weeks before and through 8 weeks after, nicotine and bone healing in a procedure this large is a very poor combination. Pre-surgical orthodontics is usually required for 6–18 months before the operation to align the teeth into the post-op bite position. Have a deep dental cleaning 2 weeks pre-op. Stock several weeks of liquid and soft foods, multiple kinds because flavour fatigue is real. Buy feeding syringes or wide-mouth bottles for the first 1–2 weeks when mouth opening is limited. Expect 5–10% body-weight loss in the first month; this is normal and the weight returns as soft diet expands. Plan for a low mood around days 4–7 when swelling peaks and communication is hardest, this is documented and transient, not a sign anything has gone wrong. Arrange substantial home help for the first 4 weeks; some patients arrange for a family member to stay with them.
The day of surgery
Double jaw surgery is performed under general anaesthesia, runs 4–6 hours, and requires 3–5 nights in hospital. Both upper and lower jaws are cut, repositioned, and fixed with titanium plates and screws. All incisions are inside the mouth. You wake up in a step-down or recovery ward (ICU only if the surgeon flagged a specific risk) with a compression bandage around the entire lower face, drains, a nasal tube, and elastic guide bands across the teeth to steer the new bite. Modern Korean orthognathic surgery uses rigid titanium plate fixation, not wired-shut jaws, the elastics guide occlusion, they don't immobilize. Significant swelling is already underway. Talking is essentially impossible for the first 24 hours. Communicating by phone or notepad is standard.
Days 1–3: peak swelling
Swelling peaks day 3–5 and is the most dramatic of any procedure in this catalogue. The face is unrecognizable. Pain is moderate to significant and managed by IV medication. The new bite feels foreign and uncomfortable. Drains usually come out by day 2–3. Strict liquid diet through a syringe or special spout because mouth opening is severely restricted from swelling and the guide elastics. Numbness across both jaws, lips, chin, and palate is universal. Do not blow your nose for 3–4 weeks: the Le Fort I osteotomy of the upper jaw opens into the maxillary sinus, and blowing your nose can push air into the soft tissues of the face (subcutaneous emphysema) or seed an infection. Sneeze with your mouth open.
Week 1: stitches out, bruising fades
Discharge usually day 3–5 once swelling stabilizes and the bite is functioning. The compression bandage may come off or be reduced. Swelling is still dramatic. Liquid diet continues. Mouth opening is severely restricted; some patients have elastic bands across the teeth to guide the bite for several weeks. Mouth rinses after every intake. Numbness is significant.
Weeks 2–4: back to public
Most patients stay home for the full first month. Public-facing situations are not realistic until week 4–6 because of swelling. Soft-liquid diet (very smooth porridge, blended soft foods) starts around week 2–3 depending on bite stability. Mouth opening slowly improves. Numbness is improving but extensive. Speech sounds slurred and improves over weeks.
Months 2–3: swelling resolves
Swelling drops dramatically between week 6 and month 3 and the new face shape becomes recognizable. Soft diet expands gradually. By month 3 most patients can chew soft-textured foods but not yet anything hard or chewy. The bite settles into its new position. Numbness in the lower lip, chin, and palate continues to improve but is the slowest-recovering of any procedure.
Months 6–12: the final result
Bone consolidation runs 6–12 months. By month 6 the cosmetic result is essentially final and most patients can eat a normal diet. Numbness in the lower lip and chin is largely resolved for most by month 6, but 10–15% of patients report some persistent altered sensation at 12 months and under 5% have it permanently. This is among the highest persistent-numbness rates of any cosmetic procedure. Functional bite refinement with orthodontics often continues for 6–12 months after surgery.
Red flags: when to call the clinic
Call the clinic the same day for: fever over 38.5°C after day 3, sudden firm painful one-sided swelling, pus or foul taste from incisions, sudden bite shift that wasn't there before (possible hardware loosening), bleeding inside the mouth, numbness getting worse rather than better, or jaw locking. Go to an emergency room for: difficulty breathing or sudden severe airway swelling in the first 72 hours (the airway risk is highest of any procedure here because both jaws are involved), chest pain, or sudden severe headache with vision changes. Routine numbness, severe mouth-opening restriction, slurred speech, and asymmetric swelling in the first 4 weeks are not red flags.