Side Effects of Maxillofacial Surgery: Risks, Complications & Prevention

Every surgery has risks. The good news is that the side effects of maxillofacial surgery are well studied, mostly temporary, and largely preventable with the right surgeon and the right preparation.

Maxillofacial surgery — whether performed for facial trauma, jaw alignment, tumour removal, or reconstructive purposes — carries a defined set of risks and complications. Major complication rates sit below 5% in most elective cases, and most side effects resolve within weeks to months. Understanding these risks before surgery helps you prepare, follow recovery instructions correctly, and recognise early warning signs if anything goes wrong. This guide covers the common short-term side effects, longer-term changes, rare but serious complications, and the practical steps you can take to lower your risk before and after orthognathic and other maxillofacial procedures.

Common Side Effects

These are expected after most maxillofacial procedures and resolve with time. They are signs that the body is healing, not signs that something has gone wrong.

• Swelling — peaks at day 3, mostly gone by 2–3 weeks
• Bruising — usually settles in 2 weeks
• Pain or tightness — well managed with medication
• Numbness — temporary; usually improves over 3–6 months
• Limited mouth opening — improves with jaw exercises
• Nasal stuffiness (after upper-jaw surgery) — settles in 1–2 weeks
• Difficulty chewing for 4–6 weeks
• Mild weight loss in the first month

Swelling and bruising

Facial swelling is the most visible side effect. It typically peaks around 72 hours after surgery and then gradually subsides over the next two to three weeks. Bruising along the jawline, cheeks, or under the eyes often accompanies swelling and fades within ten to fourteen days. Cold compresses in the first 48 hours, head elevation while sleeping, and avoiding salty foods help reduce both.

Pain, tightness, and limited mouth opening

Discomfort after jaw or facial surgery is expected and well controlled with prescribed analgesics. Tightness in the cheeks, lips, or jaw is common because the muscles and soft tissues adapt to the new bone position. Limited mouth opening (trismus) usually improves within four to six weeks with guided jaw-opening exercises prescribed by your surgeon or therapist.

Numbness and altered sensation

Temporary numbness of the lower lip, chin, cheek, or tongue is one of the most common side effects of jaw surgery. It happens because the sensory nerves that pass through the surgical site are bruised or stretched during the operation. Most patients regain normal sensation over three to six months, and gradual improvement often continues for up to a year.

Diet, elastics, and weight changes

You will start on a liquid diet and gradually progress to soft and then normal foods over four to six weeks. Many patients lose two to four kilograms in the first month because chewing is restricted. Inter-arch elastics (small rubber bands that guide the bite) are worn for several weeks to help the new bite settle into place. Skipping or removing them too early can delay healing or compromise the final result.

Longer-Term Side Effects

Most side effects fade within weeks, but a few changes can take months to settle or may persist in a small way.

• Residual numbness — a small patch on the lip, chin, or cheek may remain mildly altered in under 5% of cases
• Bite changes — the bite continues to "settle" for 6–12 months as bone heals and orthodontics finishes
• Small relapse — the jaw can shift a few millimetres back toward its original position; significant relapse is uncommon
• Scarring — incisions are usually inside the mouth, so visible scars are rare; skin incisions heal to thin lines that fade over time
• Plate or screw sensation — some patients feel thin plates under the gum, especially in cold weather; removable if bothersome
• TMJ adaptation — the jaw joints adapt to the new position; mild clicking or stiffness can occur temporarily

These long-term changes are usually minor. If they affect function or comfort, small touch-up procedures or hardware removal can be discussed during your follow-up visits. To learn how these changes fit into the overall recovery journey, see our guide on complete healing timeline and care tips after jaw surgery.

Serious Complications

These are uncommon in experienced hands but should be discussed openly during your consent visit.

• Infection — 1–5% of cases; treated with antibiotics
• Bleeding — usually minor; very rarely needs transfusion
• Persistent numbness — under 5% long-term; usually partial
• Hardware issues — plates may need removal in 5–10%
• Relapse — the jaw shifts back slightly; small in 90%+ of cases
• Non-union — the bone doesn't heal; rare (<1%)
• Tooth injury — adjacent teeth may need root canal; rare
• TMJ symptoms — temporary or occasionally persistent
• Adverse reaction to anaesthesia — discussed at pre-anaesthesia check

Infection

Surgical-site infection occurs in roughly 1–5% of elective jaw surgery cases and is more common in patients who smoke, have uncontrolled diabetes, or have poor oral hygiene. Most infections respond well to oral or intravenous antibiotics. Untreated infection near a bone cut can rarely lead to non-union, so early reporting of fever, increasing pain, foul discharge, or wound breakdown is essential.

Non-union of bone

Non-union means the bone segments fail to fuse together. The reported rate is well under 1% in healthy patients, but it rises in smokers, in patients on long-term steroids, and in those who have had radiation therapy to the face. When non-union occurs, a second surgery with bone grafting is usually needed.

Nerve injury

The inferior alveolar nerve (which gives feeling to the lower lip and chin) and the lingual nerve (tongue sensation) are at risk during lower-jaw surgery. Most nerve injuries are temporary stretch or bruising injuries that recover. Permanent complete numbness is uncommon. Upper-jaw surgery carries a smaller risk to the infraorbital nerve, which supplies the cheek and upper lip.

Bleeding

Significant bleeding is rare. Most patients notice minor oozing from the incision site for the first day or two. Blood transfusion is needed in fewer than 1% of elective cases. Patients on blood thinners are asked to stop them before surgery under medical supervision.

Jaw joint (TMJ) issues

The temporomandibular joints adapt to the new bite, but in some patients pre-existing TMJ symptoms can worsen or new symptoms can appear. Clicking, mild ache, or stiffness usually settles with physiotherapy and bite stabilisation. Persistent symptoms may need targeted TMJ treatment. Read more about TMJ causes and care in our TMJ disorder overview.

Anaesthesia-related risks

Modern anaesthesia is very safe for elective maxillofacial surgery. Risks include sore throat, nausea, and very rarely allergic reactions or breathing complications. Your anaesthesiologist will review your medical history, allergies, and previous reactions during the pre-anaesthesia check to minimise these risks.

For procedure-specific risks, see orthognathic surgery, our complete jaw surgery guide for patients, and facial trauma care. If your surgery is planned to address airway or sleep-related issues, the risks and benefits differ — see can jaw surgery help with sleep apnea for details.

Risk Factors That Increase Complications

Not every patient carries the same level of risk. The most common factors that raise complication rates after maxillofacial surgery include:

• Smoking — the single biggest modifiable risk. Smoking reduces blood flow to bone and soft tissue, increases infection risk threefold, slows wound healing, and significantly raises the rate of non-union
• Uncontrolled diabetes — high blood sugar impairs immune function and bone healing; tight control before surgery lowers risk substantially
• Age — patients over 40–45 years may heal slightly slower and have a marginally higher rate of nerve-related symptoms, though outcomes remain good
• Prior jaw or facial surgery — scar tissue and altered anatomy can make revision procedures technically harder
• Poor oral hygiene — active gum disease raises infection risk; a professional cleaning before surgery is often recommended
• Medications — long-term steroids, immunosuppressants, and bisphosphonates can affect bone healing and infection risk
• Nutritional status — low protein, low vitamin D, or low iron levels delay recovery and wound healing

Identifying and addressing these factors before surgery is one of the most effective ways to lower your personal risk.

Prevention & Risk Reduction

The biggest predictors of a safe surgery are:

• Choose the right surgeon — see how to choose the best maxillofacial surgeon in Hyderabad
• Optimise your health — stop smoking, control diabetes, address anaemia, lose weight if needed
• Follow pre-op instructions — fasting, medications, orthodontics
• Follow post-op instructions — diet, hygiene, medications, jaw exercises, follow-ups
• Recognise early signs of infection, bleeding, or relapse
• Stay close to your surgical team in the first week

Pre-operative planning

Thorough pre-operative planning is the foundation of a safe surgery. This includes detailed clinical examination, study models, photographs, CBCT scans, and orthodontic records. Modern virtual surgical planning (VSP) lets your surgeon rehearse the operation in 3D, design custom guides and plates, and predict the final bite and facial profile before you ever enter the operating room.

Smoking cessation

Stopping smoking at least four to six weeks before surgery — and continuing for several weeks after — meaningfully reduces the risk of infection, wound problems, and bone-healing complications. Even a short period of abstinence improves tissue oxygen delivery.

Oral hygiene and nutrition

A professional dental cleaning before surgery, gentle brushing with a soft brush after surgery, and salt-water rinses keep the surgical site clean. A high-protein, vitamin-rich diet during recovery supports tissue and bone healing. Hydration is equally important, especially in the first two weeks when intake is restricted to liquids and soft foods.

Follow-up visits

Scheduled follow-ups let your surgeon monitor healing, adjust elastics, review orthodontic progress, and catch any early signs of relapse or hardware issues. Skipping follow-ups is one of the most common avoidable causes of poor outcomes.

How Surgeons Minimise Risk

Modern maxillofacial surgery is safer than it has ever been, thanks to advances in imaging, planning, and instrumentation:

• 3D CBCT imaging provides precise views of bone, teeth, nerves, and sinus anatomy
• Virtual surgical planning (VSP) lets the team simulate the operation, design custom guides, and fabricate patient-specific plates
• Piezoelectric instruments cut bone with ultrasonic vibrations, sparing soft tissues and nerves
• Intra-operative nerve monitoring helps the surgeon protect the facial and trigeminal nerves during complex procedures
• Titanium plates and screws provide rigid fixation that allows early jaw function and faster recovery
• Multidisciplinary care — close coordination between surgeon, orthodontist, anaesthesiologist, and physiotherapist improves outcomes

These advances have made modern jaw surgery more predictable, less invasive, and easier to recover from than procedures performed even a decade ago.

What to Do If You Notice a Complication

Recognising early warning signs and acting quickly can prevent a small issue from becoming a serious one. Contact your surgical team right away if you notice any of the following:

• Fever above 38°C (100.4°F) or chills
• Increasing pain, swelling, or redness after the first few days
• Foul-smelling or pus-like discharge from the incision
• Heavy or persistent bleeding that does not stop with gentle pressure
• Sudden severe numbness or loss of function
• Difficulty breathing or swallowing
• Loose hardware, broken elastics, or a sudden change in your bite

For acute facial injuries after surgery — such as a fall, a blow to the face, or a suspected broken jaw — seek emergency care immediately. Our guide on emergency treatment for facial injuries near Hyderabad outlines what to do in those situations.

Realistic Recovery Expectations

Recovery after maxillofacial surgery is a staged process. Most patients can expect:

• Week 1: swelling peaks, soft liquid diet, rest, and help at home
• Weeks 2–3: swelling reduces, bruising fades, return to light work or study
• Weeks 4–6: soft diet, jaw exercises, gradual return to normal activity
• Months 2–3: most visible side effects gone, bite stabilising, orthodontics continues
• Months 6–12: final healing, residual numbness settled or near-final, results clearly visible

Patience matters. Comparing your week-two appearance to a final result is one of the most common sources of unnecessary worry. Your surgical team will guide you through each stage so you know what is normal and what deserves attention.

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