Corrective Jaw Surgery

Overview
After you have undergone a surgical procedure to correct the position of your upper jaw, lower jaw, or both, attention must be given to several aspects of postoperative care in order to help make the recovery as quick and easy as possible. Since surgery produces soreness in the muscles and bones of the jaw as well as the lips, nose and other areas of the face, some difficulty is encountered in performing such tasks as eating, drinking and cleaning your teeth. However, each of these things must be done continuously and carefully to avoid postoperative problems. This is a list of instructions which should help you in your postoperative recovery.


Diet
For now, it is important you maintain a STRICT LIQUID DIET ONLY. The plates and screws used to secure the jaw(s) in their new position take 6 weeks to stabilize, and thus your diet will need to progress slowly. Do not use a straw for the first 48 hours after surgery as it can create more bleeding. Avoid cold milk products for 48 hours after surgery as it can adhere to the incision sites and may promote infections. Attempt to drink from a cup as soon as possible, as this is the most effective way to take in liquids. Sometimes the use of a toddler “sippy cup” can help. If drinking from a cup seems to be impossible, another alternative is to obtain a squeeze bottle to squirt fluid into your mouth. This type of device can be obtained at most department stores, sporting goods stores, or bicycle shops. Examples of nutrition that is safe to consume are:
  • Protein shakes and smoothies
  • Soup broth at a warm temperature
  • Gatorade and water
PAIN MANAGEMENT
Baseline Pain Control Regimen
  • 650 mg Tylenol (Acetaminophen) 2 x 325 mg tablets, or liquid equivalent, 4 times per day. Breakfast, lunch, dinner, and right before bed. (Avoid Tylenol if you have been told not to take this medication or have liver failure)
  • 600 mg Advil (Ibuprofen) 3 x 200mg tablets, or liquid equivalent, 4 times per day. Breakfast lunch, dinner, and right before bed. (Avoid ibuprofen if you have been told not to take this medication or if you have a history of stomach ulcers or kidney disease)
  • Healthy people who stay properly hydrated can maintain this baseline pain control regimen for up to 3 weeks without any side effects. It is extremely important to maintain hydration in the post-operative period. If you are still needing this pain control after 3 weeks notify your surgeon.
If Additional Pain Control is Needed
  • 2.5 – 5 mg Oxycodone ½ – 1 x tablet, or liquid equivalent, up to 4 times per day if needed for additional pain control.
  • Do not stop taking the baseline pain control regimen if you need the oxycodone

Postoperative pain control is of paramount importance to us and our patients after surgery. We want you to be as comfortable as possible as you recover from your surgery. When you return home and the local anesthesia (numbing medicine) wears off, you will transition to oral pain medications to assist in pain control. The goal of postoperative pain management is to use oral pain medications to reduce pain to a tolerable level while the body heals and reduces pain naturally overtime. This may result in a maximal oral medication regimen which can be progressively decreased over the recovery process. Modern medicine uses three common classes of medications to achieve this goal, Acetaminophen (e.g. Tylenol), Non-Steroidal Anti-Inflammatory Drugs (NSAID e.g. Ibuprofen/Advil), and opiates (e.g. Oxycodone). Each act on different pain pathways within the body which allows them to all work synergistically at the same time. Using different classes of pain medications allows us to maximize the potential benefits of any one class while minimizing their respective side effects. During the postoperative period we want to maximize your pain control while minimizing any potential side effects. All pain medicine should be used in an “as needed” fashion. If you are not in pain, you do not need to take pain medicine. However, the baseline pain control regimen outlined above can be more effective if taken on a “scheduled” basis, regularly spaced time intervals, during the postoperative period where significant pain is anticipated. The baseline pain control regimen is more effective if taken on a “scheduled” basis rather than waiting for significant pain before taking the pain medicine. This “scheduled” strategy allows you to maintain a constant level of pain control in your blood which ultimately results in more effective pain control. If you would like to take the baseline pain control regimen on a “scheduled” basis to maximize its effectiveness we recommend taking these medications ~ 4 times per day, convenient times for most patients are breakfast, lunch, dinner, and right before you go to bed. The baseline pain control regimen can be taken together as instructed above for up to 1 week without concern for significant side effects in a healthy patient. However, if you find yourself continuing to need a “scheduled” baseline pain control regimen after 1 week, please let us know so we can make sure that you are healing appropriately. Opiate derived pain medications, like oxycodone, have rightfully received a lot of attention in the media recently due to their addictive potential. While this class of medication can be addictive it is important to note that addiction occurs when these medications are used for prolonged durations for chronic pain, not for acute postoperative pain. As such, these medications are safe to use as prescribed for a short duration after your surgery. However, they have other side-effects as well such as nausea, constipation, and drowsiness which are undesirable. As a result, we still reserve this class of medication for as needed additional pain control if the baseline pain control regimen above is insufficient. We hope all our patients recover as painlessly as possible. However, recovering from surgery is typically uncomfortable. The strategies and philosophies outlined above will not make the recovery from surgery painless, but they should serve to reduce the pain to a tolerable level while the body heals and subsequently reduces pain naturally. If you ever feel that the pain is unbearable despite these medications, please let us know so we can make sure that you are healing appropriately.
PRESCRIPTION MEDICATIONS
In addition to the prescription for oxycodone you will be given several other prescription medications to aid in your recovery.
  • Antibiotics: You will be given a prescription for an antibiotic such as amoxicillin or clindamycin, etc. This medication should be taken at the appropriate interval as described on the bottle. Be sure not to miss any doses and take the medicine until it is gone. Note: Some types of antibiotics reduce the contraceptive effects of birth control pills.
  • Anti-Nausea Medicine: You will be given a prescription for Zofran (Ondansetron). If you are feeling nauseated after surgery this medication can be placed under the tongue. When placed under the tongue it will dissolve and be absorbed by your body. This medication should only be used if you are nauseous. It can be taken once every 6 hours if nausea persists.
  • Mouth Wash: You will be given a prescription for Peridex (Chlorhexidine) which is a mouth wash that can help substitute for tooth brushing in the first week. Swish gently with ~15ml of this medication for 30 seconds and spit.
OVER-THE-COUNTER MEDICATIONS
Below are some medications available over the counter at any local pharmacy that may be helpful to aid in your recovery.
  • Decongestants:: Following orthognathic surgery, especially upper jaw surgery, there is considerable stuffiness of the nose and sinuses. If a decongestant is recommended, take the medication as indicated on the bottle for seven to ten days or as needed for congestion. A decongestant such as Sudafed® is better for clearing up a runny nose while a decongestant such as Mucinex® (Maximum Strength or DM) will better aid with thinning excess mucus secretions and build up in the back of the throat. Note: During this time, keeping the head elevated with a pillow or two will aid with the flow of congestion and keep secretions from building up in the back of the throat overnight. This will make sleeping a little easier. Do not blow your nose for 10 days after you had upper jaw surgery.
  • Nasal Spray: (Afrin®, Neosynephrine® or equivalent) can be used as six to eight hour intervals to help improve breathing through your nose. In order to prevent overuse of the nasal spray, this can be alternated with plain saline (salt water or ocean spray) nasal spray. These sprays can be purchased from your pharmacy.
  • Lip Ointment: You will be given a tube of lip ointment at the hospital. Use this for the first two days. Keep enough ointment on the lips to keep them looking wet. After two days stop using the ointment and use plain Vaseline®.
  • Stool Softener: Taking an opiate derived pain reliever like oxycodone will eventually cause constipation. You can take Miralax (or a generic version), a very effective stool softener, while you are taking oxycodone to avoid constipation. Take as directed on the bottle.
ORAL HYGIENE
Maintaining proper oral hygiene can be extremely difficult post-operatively, but it is incredibly important to help prevent an infection from developing. We recommend purchasing a baby toothbrush as the smaller size and soft bristles will make it easier to keep your braces and teeth clean. It is important you brush your teeth at least twice a day, taking care to clean the front of your teeth and braces only (do not clean the gums because your surgical incisions are in that area). You may also be prescribed an antibacterial mouth rinse (e.g. Chlorhexidine) that can be used twice a day to help clean and prevent infection. Do not use a water pik or electric toothbrush for the first 7 days after surgery.
SWELLING REDUCTION STRATEGY
  • First 72 hours –Limit Swelling Accumulation
    1. Apply ice to limit accumulation of swelling. 20 minutes on and 20 minutes off while awake. (e.g. ice packs and head wrap provided, frozen peas/corn)
    2. Elastic facial dressing (jaw bra): This elastic bandage should be kept in place as much as possible for the first 24 hours without the ice if sleeping. After the first day, this bandage is not essential, but may help reduce swelling more quickly. Wearing this dressing at night will also help reduce swelling more quickly.
    3. Elevate your head while sleeping and resting by using several pillows such that your head is above your heart. This will help reduce swelling accumulation.
    4. Take NSAIDs (Ibuprofen/Advil) if instructed as part of the baseline pain control regimen above
  • After 72 hours – Promote Resolution of Swelling
    1. Apply moist heat to promote drainage of swelling which has accumulated during initial healing phase. (e.g. clay heat packs sold in drug store, moist towel heated in microwave)
    2. Continuing to elevate your head while sleeping and resting by using several pillows such that your head is above your heart. This will improve swelling draining from the face.

  • Swelling is a natural part of your body’s healing process. During the early phases of recovery from surgery tiny vessels called capillaries become increasingly porous resulting in fluid escaping and accumulating in your tissues. This accumulation of fluid allows for your body’s healing machinery to access the injured area. However, this typically results in undesirable tension and a reduction in range of motion of muscles in the area. Both of these things can contribute to postoperative pain and discomfort which is why we attempt to reduce postoperative swelling, although we will never eliminate it completely.
  • Swelling is a natural part of your body’s healing process and typically begins hours after surgery ends and continues to increase over the next 48 to 72 hours. As a result, we expect the average patient to be the most swollen on ~ day 3 after surgery. During this period of increasing swelling we have two methods of reducing swelling, ice and NSAIDs (Ibuprofen/Advil). Ice causes constriction of the small vessels in the area which results in a reduction of the fluid that escapes and thereby reducing the accumulation of swelling. Ice should only be applied when a patient is awake because prolonged application of ice can result in burns. We recommend 20 minutes of ice application to the affected area and a 20 minute period to allow the tissue to recover, repeating this cycle while you are awake. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen/Advil reduce signaling pathways in your body which reduce pain mediators and the accumulation of swelling.
  • We expect swelling to peak ~ 72 hours after surgery and then slowly dissipate. Swelling typically takes much longer to dissipate than to accumulate. During this period of swelling resolution we have two methods to reduce swelling, moist heat and elevation. Moist heat promotes dilation of the small vessels in the area and allows the body to recapture accumulated fluid and remove it from the affected area more efficiently. Moist heat should be warm, but not so hot that it causes discomfort. Moist heat can be applied using warmed heating pads available at most pharmacies or with a damp towel heated in the microwave for a short duration. Elevating the surgical area allows gravity to naturally pull swelling from the surgical site. During the day most patients naturally elevate their head, however, sleeping on several pillows such that the head remains elevated at night as well can further expedite the resolution of the swelling.
  • Swelling is part of your body’s natural healing process and we cannot eliminate it entirely. Swelling typically peaks ~ 72 hours after surgery and can contribute to postoperative pain and reduced mobility while healing. We can reduce its accumulation and promote is resolution by implementing the strategies outlined above.
ELASTICS (RUBBER BANDS)
Post-operative elastics are crucial to help establish and stabilize your new bite. Depending on your surgical movements, we will show you the location and quantity of elastics that you will be using in the post-operative period. These will change over time, so at each follow-up appointment we will review your elastic use and location as well as provide you with a diagram. You will also be provided with extra elastics and an “attacher” to use should an elastic fall off or break. Please be sure to secure this “attacher” in a safe location. It is normal that the elastics will limit your jaw movement; this is intentional.
PHYSICAL ACTIVITY
Following surgery, you will find that your energy level is much lower. This will take some time to return to normal. when you attempt to return to normal physical activity start slowly and work up to your normal level. Physical exercise such as walking can begin immediately after surgery once you feel able. Other than a light walk, there should be no cardio or weight lifting exercises at this time. Jogging can begin 3 weeks after surgery, light weights 4 weeks after surgery, and heavy lifting or contact sports 6 weeks after surgery. Begin by going shorter distances and at a slower pace than usual to be sure you feel up to the exercise. As your endurance and confidence improve, gradually increase the level of exercise within a level of comfort.
SUTURES
  • There will be sutures inside your lip where the incisions were made. These sutures will fall away on their own after 7-14 days. If the sutures fall away early, do not worry, they do not need to be replaced
  • If you had lower jaw surgery, there will also be one suture on each cheek. These sutures will also fall away on their own and do not need to be removed.
JAW EXERCISES
Do not attempt to specifically stretch your jaw at this time, passive opening is ok for eating and hygiene. It is normal to have a restricted motion and for your muscles and bones to be stiff and sore. Jaw exercises will be introduced later in your recovery period.


DIET
You can now begin to progress your diet to a soft, non-chew diet. Remember, the plates and screws used to secure the jaw(s) in their new position take 6 weeks to stabilize, and thus your diet will need to progress slowly. Using a baby spoon can be helpful as it will still be difficult to open your mouth. Examples of food that is safe to consume are:
  • Mashed potatoes
  • Applesauce
  • Oatmeal and pudding
  • Very soft scrambled eggs or pancakes
  • Any liquids
  • Any pureed food
PAIN MANAGEMENT
At this stage most patients are beginning to reduce the amount of pain medication they require as their post-operative discomfort naturally decreases. As your discomfort decreases, you should start be tapering off of the oxycodone, while maintaining the Tylenol and Ibuprofen usage if necessary. Once you are no longer taking oxycodone you can slowly decrease the amount of Tylenol and Ibuprofen, by progressively taking one less pill at each 6-hour dosing interval. It is normal for patients to need some Tylenol and Ibuprofen for up to 3-4 weeks after surgery. As long as you are staying hydrated, continuing to use the Tylenol and Ibuprofen 4 times per day is completely safe. If you still needing the maximum dose of Tylenol and Ibuprofen 4 weeks after surgery, please let your surgeon know.
ORAL HYGIENE
Maintaining proper oral hygiene can be extremely difficult post-operatively, but it is incredibly important to help prevent an infection from developing. We recommend purchasing a baby toothbrush as the smaller size and soft bristles will make it easier to keep your braces and teeth clean. It is important you brush your teeth at least twice a day, taking care to clean the front of your teeth and braces only (do not clean the gums because your surgical incisions are in that area). You may also continue to use the antibacterial mouth rinse (Chlorhexidine) which can help supplement for tooth brushing until you are able to adequately brush your teeth. It is now safe to use a water pik or electric toothbrush if desired.
SWELLING REDUCTION STRATEGY
At this stage the swelling should stop accumulating and start decreasing. Most of the swelling will decrease over the next 2 weeks, but the remainder of the subtle swelling can take up to 6 months. In order to encourage the swelling to dissipate more quickly:
  • Apply moist heat to promote drainage of swelling which has accumulated during initial healing phase. (e.g. clay heat packs sold in drug store, moist towel heated in microwave).
  • Continuing to elevate your head while sleeping and resting by using several pillows such that your head is above your heart. This will improve swelling draining from the face.
ELASTICS (RUBBER BANDS)
Post-operative elastics are crucial to help establish and stabilize your new bite. It is normal that the elastics will limit your jaw movement; this is intentional. We will evaluate your bite and advise on the quantity of elastics to use and length of time and provide you with an elastic diagram.
PHYSICAL ACTIVITY
Other than a light walk, there should be no cardio or weight lifting exercises at this time. Jogging can begin 3 weeks after surgery, light weights 6 weeks after surgery, and heavy lifting or contact sports 3 months after surgery. Begin by going shorter distances and at a slower pace than usual to be sure you feel up to the exercise. As your endurance and confidence improve, gradually increase the level of exercise within a level of comfort.
JAW EXERCISES
Do not attempt to specifically stretch your jaw at this time, passive opening is ok for eating and hygiene. It is normal to have a restricted motion and for your muscles and bones to be stiff and sore. Jaw exercises will be introduced later in your recovery period.


DIET
You can continue to progress your diet but maintain a soft, non-chew diet. You can eat anything you would like that does not require you to place food between your teeth and bite. Remember, the plates and screws used to secure the jaw(s) in their new position take 6 weeks to stabilize, and thus your diet will need to progress slowly. Using a baby spoon can be helpful as it will still be difficult to open your mouth. Examples of food that is safe to consume are:
  • Any liquids
  • Any pureed food
  • Soft, overcooked pasta
  • Soft chicken cut or shredded into very small pieces, that can be swallowed without chewing
  • Soft flaky fish
  • Very soft ground meat cut into small pieces, that can be swallowed without chewing
  • Do not eat anything that requires you to mash it by placing food between your teeth, no pressure should be placed on the teeth during eating.
PAIN MANAGEMENT
At this stage most patients are no longer using any oxycodone, but may still be tapering off from the Tylenol and Ibuprofen. Once you are no longer taking oxycodone you can slowly decrease the amount of Tylenol and Ibuprofen, by progressively taking one less pill at each 6-hour dosing interval. It is normal for patients to need some Tylenol and Ibuprofen for up to 3-4 weeks after surgery. As long as you are staying hydrated, continuing to use the Tylenol and Ibuprofen 4 times per day is completely safe. If you still needing the maximum dose of Tylenol and Ibuprofen 4 weeks after surgery, please let your surgeon know.
ORAL HYGIENE
Maintaining proper oral hygiene can be extremely difficult post-operatively, but it is incredibly important to help prevent an infection from developing. We recommend purchasing a baby toothbrush as the smaller size and soft bristles will make it easier to keep your braces and teeth clean. Once you are able to open your mouth and adequately brush your teeth to keep your mouth clean you can stop using the antibacterial mouth since (Chlorhexidine). Continue to refrain from brushing where the incisions were made, just brush the teeth. It is now safe to use a water pik or electric toothbrush if desired.
SWELLING REDUCTION STRATEGY
At this stage ~ 50% of the swelling should have resolved. The remainder of the swelling will continue to dissipate slowly but can take up to 6 months before it is completely gone. Continuing to elevate your head while sleeping and beginning the jaw stretching exercises will continue to encourage the swelling to resolve.
ELASTICS (RUBBER BANDS)
Post-operative elastics are crucial to help establish and stabilize your new bite. It is normal that the elastics will limit your jaw movement; this is intentional. We will evaluate your bite and advise on the quantity of elastics to use and length of time and provide you with an elastic diagram.
PHYSICAL ACTIVITY
It is now safe to begin light cardio activity. Stationary bike, brisk walking, or jogging can begin. However, heavy lifting or contact sports need to wait until at least 6 weeks after surgery. Begin by going shorter distances and at a slower pace than usual to be sure you feel up to the exercise. As your endurance and confidence improve, gradually increase the level of exercise within a level of comfort.
JAW EXERCISES
It is now safe to begin passive jaw exercises. Attempt to gradually increase the amount you can open your mouth by simply using normal jaw muscles. Some mild discomfort might be experienced but keep this within a level that is easily tolerated for a short period of time. About 5 minutes of concentrated jaw movement in the morning, during the middle of the day, and again at night should be sufficient. By the fourth week after surgery you should be able to easily get one finger between your front teeth (10-15mm opening). By the fifth week you should be able to get two fingers between your teeth (20-25mm). If you do not achieve this goal, begin “Hold and Relax” exercises. This involves opening your mouth about one half the amount you comfortably can. Fold your hand into a fist and place your fist under your lower jaw. Using gentle pressure with your hand try to push your mouth closed, use your jaw muscles to resist the pressure from your hand. Hold this pressure for five seconds. Release and spend 30-60 seconds moving your jaw side to side and try to passively stretch and open your mouth without resistance. Then repeat the hold and relax exercise. Do five repetitions of this exercise three times per day. passive jaw exercises


DIET
You can begin to progress your diet back to normal. However, you should be careful and ease yourself back into the foods you enjoy. Tougher foods like apples, carrots, and tougher meats still may be several weeks away. Imagine you have been on crutches for 6 weeks and your doctor just told you that you can walk. If you went for a long run that first day (ate steak), your body just is not ready for that yet. Common sense dictates that food still be somewhat soft and cut into small pieces, as you slowly progress back to your regular diet.
ORAL HYGIENE
You can now resume your normal, pre-operative oral hygiene routine. As always, it is important to continue to keep your mouth and braces clean to avoid dental decay.
ELASTICS (RUBBER BANDS)
Post-operative elastics are crucial to help establish and stabilize your new bite. We will evaluate your bite and advise on the quantity of elastics to use and length of time and provide you with an elastic diagram. At this stage your orthodontist will likely take over the instructions on your elastic use.
PHYSICAL ACTIVITY
It is now safe to progress to more strenuous activity. Let your body be your guide as you progress into more normal activities. It is now safe to begin progression back to sports. As always avoiding being hit in the head and face is recommended.
JAW EXERCISES
It is now safe to begin active jaw exercises. Begin with two or three repetitions of the Hold and Relax exercises you have done previously. Then, place your middle finger on your lower teeth and your thumb on your upper teeth. Apply pressure that creates a feeling that you are stretching muscles with some feeling of tightness or mild discomfort. Hold this for five seconds then release and move your jaw side to side and open and close using just your jaw muscles for 30 seconds. Repeat the finger stretching, placing your fingers on the opposite side. Do three repetitions on each side, and repeat this cycle three times per day. Each time try to slightly increase the finger pressure to produce more opening. (Do this to produce only mild discomfort, do not push enough to create significant pain.) It is normal to be sore after each session, but your soreness should recover by the next morning. If you are waking up with soreness in your jaw muscles you are likely pushing yourself too hard. Reduce your intensity or frequency such that your body can recover overnight. active jaw exercises As you can see, recovery from surgery requires a lot of effort on your part. We will be happy to answer any questions regarding diet, hygiene, elastics, exercise, or any other problem which may be of concern to you. Remember, postsurgical progress is sometimes uncomfortable and may occur slowly. However, with some determination and attention to these instructions, you can maximize your healing process. If you have any questions regarding your postoperative recovery, please do not hesitate to call us anytime at (650) 342 – 0213.

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    Dr. Adam Fagin came highly recommended by my orthodontist to correct a severe open bite as part of a treatment that I have been delaying my entire adult life. Dr. Fagin spent a significant the time reviewing my information and answering all of my questions and giving me clear insight into my diagnosis. I have never had a medical professional so clearly outline the entire treatment in such a comprehensive and transparent way. Correcting my jaw issue has been something I have been putting this off for a very long time, mostly due to a lack of understanding of what the treatment would entail. I now know exactly what will happen step by step. I'm beyond confident that Dr Fagin and his team will be able to get me through this procedure so I can one day finally be able to eat a sandwich normally.Edit/Update: Post Surgery - I am now almost 3 weeks post Double Jaw Surgery with Dr Fagin & his team, and I could not be more pleased with the results so far. Although there was expected swelling and numbness from the procedure, my swelling has gone down considerably and it's obvious that the procedure was executed by a skillful surgeon. There was also very minimal bruising on my face from the procedure which from what I've seen is not always the case. My orthodontist was also very pleased at the outcome of the bite alignment from the surgery. Every step of the way, Dr Fagin & his team have answered all of my questions, provided and reviewed with me comprehensive information packets and what to expect and the best way to manage the healing process. Dr Fagin also has a lighting fast response rate to questions we have had during the recovery which was incredibly helpful. I can't recommend Dr. Fagin enough for making me have such a positive experience for a procedure that I had been dreading for so long. It is obvious that he is not only a skilled surgeon but the attention to detail and the care he provides for his patients makes him an outstanding choice for any procedure.
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    Ashley NL
    1704844511
    I had a consult with Dr. Fagin last January for jaw surgery. From the get go he was absolutely lovely and really took the time to explain the surgery and answer my questions. Not only that but he was able to get my surgery covered by insurance, whereas other surgeons did not try. I am eternally grateful for that.I had surgery late November and just had my 6 week post op visit and have nothing but positive things to say once again! He put me at ease before and after surgery. I never felt rushed out the door, and when I had questions he was always prompt with returning my calls. Heck, the time of my appointment needed to be changed and he called me directly. I work with doctors and NEVER have had a MD call a patient directly to reschedule. I also come a distance away and that was always something he remained cognizant of, even since the initial consult. He was always upfront about what to expect and guidelines to follow and I felt like because of it I had an easy recovery. I've heard horror stories of surgery and was worked up over it but it was infinitely better than I ever could have hoped for. I also had a brief interaction with Dr. Loi for botox and she was lovely as well!I am very happy to have been referred and done the surgery. I'm thrilled with the results and legit couldn't have asked for a better surgeon or experience. His office staff is also lovely! I had many many questions with insurance and time off work papers and they were always very patient and kind and so willing to help.I would highly recommend to anyone. Even being a 6 hour round trip, it was was worth making the drive to be treated. Thank you again to everyone!
    Had a tooth from hell!! Dr. Fagin and his staff got me all set up. Put in an IV and literally it felt like 5 minutes later I was waking up and I literally don’t remember a single thing. Thank you Dr. Fagin and staff for a pleasant experience even though I don’t remember most of it! Top shelf care! 100% recommend him and his staff if you need oral surgery!
    I had originally started the process to have jaw surgery with a different surgeon, but that didn't work out. I found Dr. Fagin on my insurance website as an in-network doctor (Aetna). The first appointment was the consultation and I was very happy because he spent nearly an hour going over every detail with me and showing me all kinds of before & after pictures. He was very realistic and honest with setting expectations. He was also receptive to my questions and concerns. His office staff has been wonderful as well and super helpful. The surgery went very well. I'm just over two months post-op and everything seems to be going as planned. I like the look of my face, my bite is good, and my breathing is excellent. I would 100% recommend him to anyone who needs jaw surgery. My pictures aren't the best, but I wanted to show the improvement.
    Estér Alves
    Estér Alves
    1699574687
    Dr. Adam Fagin was wonderful. His knowledge and professionalism were evident from the start and that made me sure I was in the right place to get my surgery done. He took the time to patiently explain the procedure and answer all my questions, which certainly alleviated the concerns I had. Throughout the treatment, Dr. Fagin was gentle and attentive, ensuring I was comfortable at all times. The professionalism, expertise, and genuine care demonstrated by the entire team truly sets them apart.The reception staff were friendly and efficient, making the check-in process always super quick. The waiting area was clean and comfortable, and I dont think I ever had to wait more than 2 minutes before being called in for my appointment. I am truly amazed by this place and team!
    Hunter Gillies
    Hunter Gillies
    1699561017
    I saw Dr Fagin for an implant. At the outset he and the staff were very compassionate and explained all of my options thoroughly. Long story short, first implant failed and I was disappointed but it was probably due to my underlying diabetes. Dr Fagin again was very compassionate and ran through all of my options and was completely open to my concerns and needs. He repeated the procedure which was successful. I would highly encourage you to visit Dr Fagin, his expertise, compassion and patience is all one can ask for!
    Han Liu
    Han Liu
    1698555347
    I was initially terrified of having jaw surgery. I had heard stories about the long and painful recovery, and I was worried about the potential complications. But after my experience at Peninsula Oral and Facial Surgery, I can honestly say that the surgery was much better than I ever expected.The staff at Peninsula Oral and Facial Surgery is dedicated and supportive. Emily and Marissa helped me navigate my insurance coverage and answered all of my questions about the procedure. My surgeon, Dr. Adam Fagin, is a true expert in his field. He took the time to explain my condition and the procedure in detail, and he made sure I was comfortable and understood everything before we proceeded. Dr. Fagin is also incredibly patient and available for his patients. He always answered my calls and emails promptly, and he made sure I had everything I needed for a smooth recovery.The procedure itself went flawlessly, and I was amazed at how quickly and efficiently Dr. Fagin completed it. I experienced minimal discomfort and got discharged out of the hospital in less than 24 hours, and I was back to my normal routine within a few weeks.I am so grateful for the excellent care I received at Peninsula Oral and Facial Surgery. I am so glad that I chose to have my surgery here as a specialized facility, rather than at a big hospital facility. The personalized care and attention I received at Peninsula Oral and Facial Surgery made all the difference.I highly recommend Peninsula Oral and Facial Surgery to anyone seeking oral and facial surgery care. They are the best in the business!
    Junlin Chen
    Junlin Chen
    1698550339
    Dr. Loi is an outstanding dental professional. Following referrals from three other dental practitioners for wisdom teeth extraction and an evaluation of a potential odontogenic tumor, Dr. Loi's expertise shone through.Her precise diagnosis, based on extensive experience and meticulous 3D x-ray analysis, was commendable. In under an hour, she adeptly removed all 4 of my wisdom teeth, avoiding the need for more complex surgery to address the benign growth underneath. Thanks to her skill, the healing process that I'm undergoing now is virtually painless.I'm deeply grateful to Dr. Loi for her exceptional care and expertise.
    Julie Mell
    Julie Mell
    1698457248
    Sharing gratitude and recommending Dr. Adam Fagin at the Peninsula Oral and Facial Surgery center in San Mateo, CA for the kind, compassionate and through work done on an overdue implant.Dr. Fagin's practice is clean, comfortable, friendly and top of the line when it comes to technology.I appreciated his attention to detail in explanation of what to expect and why he chose the procedure he chose.I live on the coast and making the drive to San Mateo was easy and quick to get there.Thank you Dr. Fagin and staff.
    Went in for an emergency infection. Dr. Loi took care of it within 2hrs and im really grateful. I got really bad anexity and panic attack but Dr. Loi assured that everything gonna be alright. She guided me every step and making sure im good. I really appreciated what she did and also staff its really friendly and comforting. Highly recommend if any of person needed an emergency oral surgeon.
    Stefanie Yoo
    Stefanie Yoo
    1697330534
    I reached out after getting a referral for my broken front tooth on a Saturday. It was able to get a response and consult over text messages within 30 mins. It was very reassuring to get professional advice and be able to make an appointment for Monday.
    Jeannie Vaughn
    Jeannie Vaughn
    1696374038
    I had to have a last minute oral surgery with a surgeon I had never been to. Needless to say this can be intimidating as well as scary. Dr Fagin was confident while pleasant and kind yet not arrogant, this was very disarming. I was at ease. He was knowledgeable and precise. The fact that he and his father work in the same place made it very easy to see the years of wisdom he has tapped into played a part in this. I cannot leave this review without mentioning the staff, the kindness was very contagious. I have never met these people and still I felt like I had been a patient for years. Thank you for your great teamwork, this takes real effort. Kindest regards Jeannie
    Patricia Cierra
    Patricia Cierra
    1694474704
    Susan Roth
    Susan Roth
    1681263162
    Both DDS. Adam Fagin, and father Richard Fagin, are professional, caring, and excellent. My molar, #15, was pulled last week, and I experienced a bit more pain, on Sunday. DDS. Richard, packed it on Monday, with some soothing agent, and DDS. Adam checked it, again today. I’ve been in numerous times, as I was nervous, about my recovery, and the staff, and Drs, are always happy to see me, and reassuring. Fabulous bedside manner.It’s the second time, I needed an extraction, and the second review I’ve written for their office. I wouldn’t go anywhere else.“ THE BEST OF THE BEST.”
    Nate Posner
    Nate Posner
    1679611678
    I got my wisdom teeth out here with Dr. Fagin and had the best experience of anyone I’ve known who have had the same procedure. The day after the surgery I was already going places and doing what I needed to do. The day after that I was able to go to work without a hitch, and the day after that I went to school. I also got hardly any swelling which was fantastic. For the most part, people couldn’t tell I had gotten my wisdom teeth out at all and I felt very informed about the whole process.I don’t normally leave reviews but this was just a really positive experience and I want others to have a good experience with this kind of thing as well. Just be sure to listen to your dentist and you’ll be fine.
    Vidya Chadaga
    Vidya Chadaga
    1677774733
    I recently had the pleasure of being treated by Dr. Adam, and I can't recommend him enough. I was in a critical condition and needed an oral surgeon urgently. Thankfully, Dr. Adam was able to squeeze me in for a new patient appointment at a day's notice, and I'm so grateful he did. From the moment I walked into his office, I knew I was in good hands. Dr. Adam was patient, detail-oriented, and answered all of my questions, putting me at ease despite the severity of my condition.Initially, I went to Dr. Adam for a second opinion, but after meeting him and seeing how he approached my situation with care and concern, I knew I wanted him to perform my surgery. It turned out that I had a tumor, but Dr. Adam's expertise and skill made me feel confident that I was going to be okay. Throughout the entire process, he treated me like a human being, not just a patient, and that made all the difference in the world.In the end, the surgery was a success, and I'm so thankful to Dr. Adam and his team for everything they did for me. If you're looking for an oral surgeon who truly cares about his patients and delivers outstanding results, Dr. Adam is the one for you. Thank you, Dr. Adam, for your patience, expertise, and above all, your humanity.
    Kelly Ernst
    Kelly Ernst
    1677555423
    Look no further for your oral surgeon. Dr. Adam Fagin provided reassuring and expert care during a stressful time for me. He is very caring and detailed in explaining tooth extraction and implant placement. His surgical skills are superb, and I healed with no complication. I felt my care was in the best hands possible because Dr. Fagin is trained as both a physician and oral surgeon with so many years of training with the nation’s top surgeons - we are lucky that he came back to practice with his father here on the Peninsula. His team at the practice was friendly, efficient and easy to contact. Dr. Fagin and his team make dealing with surgical dental problems as good as it gets in my opinion!
    Roberta Romer
    Roberta Romer
    1675972307
    I was so nervous to get this surgery done. Dr. Fagin, who is amazing very gentle and professional. I did not feel anything during this procedure they remove two large tori bones Inside my mouth. After the procedure I felt very little pain and the healing was so quick within a few days. I was able to brush my teeth like normal. I highly recommend Dr. Adam Fagin for any oral surgery needs. 10 stars in my book.
    Angela's Family
    Angela's Family
    1673657291
    Dr. Fagin makes having a implant an OK experience. Walks you thru the whole process. Terrific follow up and great team.
    Jennie Gerlach
    Jennie Gerlach
    1672419602
    Dr. Adam Fagin worked with me to conduct a three-part jaw surgery to fix a crossbite and upper jaw slant. He did an excellent job from start to finish. At our initial consultation, he took the time to hear my concerns and to lay out the possible treatment options. He had a lovely handout that helped me visualize the pros and cons of the surgery and helped me remember the details as I went home to consider which path I was willing to take. As we moved forward, his team worked with my insurance and communicated with me so there were no surprises when it came to the financial side of the procedure. The consultations before and after surgery were excellent and so encouraging. Dr. Fagin was patient with my questions, encouraging and positive regarding the progress of my healing, and incredibly accommodating for my schedule. As for the surgery itself, it went great. Dr. Fagin showed me the surgery plan and communicated every bit of the procedure to me so I felt comfortable. The recovery was exactly as I expected it to be and I'm very pleased with the outcome. Overall, I had an excellent experience with Dr. Fagin and his team and I highly recommend him!
    Toni Rose
    Toni Rose
    1671279670
    Dr. Adam Fagin is THE best specialist I have ever been to. From the moment I had a consultation to the moment I got my wisdom teeth extracted it was truly a great experience. I got my wisdom teeth extracted yesterday and it was my first time ever being sedated. I was nervous about the whole procedure but it went by so quickly. His dental assistants Rondale and Taylor made me so comfortable before and after the procedure. As I got seated Rondale and his funny sense of humor gave me a blanket to keep me warm and suddenly my anxiety was slowly going away. Dr. Fagin came in and reassured me about any questions I had and I knew I was going to be in good hands by himself and his staff. After feeling nauseous during the procedure Taylor made sure I was doing okay, she gave me water, assisted me to the bathroom, and wheel-chaired me to my car.It’s only day two of recovery but my first day was painless mostly because I’m still numb. I’ll be sure to follow the post-op instructions to make the healing process fast and efficient. Thank you Dr. Fagin and staff.
    Andres Godoy
    Andres Godoy
    1668110877
    I would 10/10 recommended anyone to come here for any sort of dental needs! I was extremely nervous to get my wisdom teeth removed, but Dr. Fagin and his staff were extremely kind and supportive throughout the process. As for my recovery, I was provided a care package with instructions to help reduce my pain and swelling. Dr. Fagin personally called me to follow up, after the procedure and to check in on me. I enjoyed my experience, and would recommend Dr. Fagin any day!
    Linda Rolley
    Linda Rolley
    1665690702
    I was referred to Dr Adam Fagin in Jan 22 from my primary dentist for a impacted back tooth. Dr Fagin found a funny growth under my tongue. He took a biopsy.This came back as cancer. I was then referred to Dr Ryan head of oncology head,neck and throat at UCSF.It was a squamous cell tumor pushing up thru my tongue.I had major surgery in March. 6 months later my biopsies, MRI and PET/CT have all come back cancer free. I am one very lucky lady.I owe all this to Dr Fagin. If he had not taken the time and found this I don't know how long I would have gone on.He is a excellent dentist that goes above and beyond. I would recommend him to anyone for dental and more.He is kind and caring.I feel I just may owe my life to him.With the utmost respect for Dr Fagin.Linda M Rolley
    Mariana Torres
    Mariana Torres
    1663430781
    I was really nervous to get my wisdom teeth removed. I did a lot of research and my dentist highly recommended Dr. Fagin. I like most people fear the dentist and personally had bad experiences in the past. I cannot be happier with my overall experience at San Mateo Oral & Maxillofacial Surgery. The staff is super friendly and helpful. They addressed all my questions and concerns before the procedure. The day of the actual procedure was a breeze and the recovery was quicker than I expected. The doctor calls you the afternoon after the procedure to answer any additional questions in regards to the recovery. The post check up a week later was also quick and easy! I would also like to add that my insurance was out of network but their administrative staff is great so the billing process is very comprehensive and they make the claim directly with your insurance. 10/10 would recommend to anyone.
    Kimberly Clark
    Kimberly Clark
    1658552428
    My daughter recently got her wisdom teeth pulled by Dr. Fagin and everything was great but then she started to feel some pain about 10 days post surgery. We were supposed to leave for a trip out of the country the next morning and out of an abundance of caution wanted to make sure that she didn’t have an infection. We ended up calling Dr. Fagin at 8:30 pm on a Friday night for advice and he was able to meet us at his office by 9:15. He was super caring and responsive throughout the whole process and we feel lucky to have him as a surgeon. Would highly recommend Dr. Fagin and this practice.
    Irvin Ungar
    Irvin Ungar
    1658442274
    dr adam fagin was absolutely terrific - professional and knowledgeable in every sense - right away I knew he was confident and competent and did not hesitate to have him work on me - really an excellent doctor - would not hesitate to highly recommend him! Irvin Ungar
    Grace Mancilla
    Grace Mancilla
    1658441244
    They did a great job! Super nice people. And they make it easy for you to understand at what they are looking at! Overall great people and great work!! Nice place too!🙂
    Cloud Bell
    Cloud Bell
    1657588807
    Dr Adam Fagin was absolutely amazing. I was nervous about the procedure and he was so kind and patient. Once he ensured I was completely numb, he took the teeth out so quickly and efficiently I could hardly believe it! The office staff were all friendly and helpful too-I highly recommend this practice and Dr Fagin.
    YL
    YL
    1656517359
    I had an amazing experience with Dr. Adam Fagin and the staff at the clinic.I was very nervous walking in and didn’t know what to expect. Dr. Fagin explained everything to me patiently and he also listens. The entire surgery was smooth and painless. I went under full sedation and extracted all four wisdom teeth at once. He was very precise and gentle, and only cutout mini holes to do that. The staff there was very friendly, efficient, and professional as well. They gave me a blanket to keep me warm during the surgery and patiently walked me through post-surgery self-care at home. I treated it like bible and followed every step of it. it’s so helpful!Dr. Fagin is very knowledgeable and also very caring. After the surgery, he caught my potential dry socket complication early and took actions early, so it wasn’t painful at all like other people said. It also healed in 2 days.I don’t have more wisdom teeth to extract, but if I did, I would go to him again.
    Dr Adam Fagin was really helpful in my case where I was having a terrible toothache on a tooth on which another doctor had done a root canal and put a cap on. Due to a botched root canal 2 years ago, I was severely in pain and even had a fever due to infection and pus spreading. I went to see Dr Adam Fagin and he instantly treated me. He even made an effort to call me later in the evening to see if I was doing ok. He is skillful, knowledgeable and compassionate. Would highly recommend him.
    Sarah Winkel
    Sarah Winkel
    1652917838
    I was nervous to get my wisdom teeth pulled, so I put it off until they started to hurt. Because of that, I was relieved that the whole process was quick, from the consultation to recovery. Dr. Fagin came highly recommended to me. All pre-surgery instructions were clear, and I felt comfortable going into the appointment. The whole staff made me feel relaxed on the morning of surgery. Before I knew it, the entire procedure was over and I was on my way to recovery. Dr. Fagin made me feel very at ease and was patient to answer all questions. Overall, they turned a stressful situation into a pretty positive experience.
    Serena Nash
    Serena Nash
    1652154782
    I had my wisdom teeth removal with Dr. Adam Fagin. From my first consultation through follow-up appointment Dr. Fagin & his team provided excellent care, were consistently informing me about the procedure and were incredibly comforting throughout the process. For my actual wisdom teeth removal I experienced almost no pain immediately after and in the days recovering from the surgery. The procedure itself went by very quickly, and following the teams instructions led me to a very speedy recovery- by days 3 & 4 I felt back to normal already and could eat/talk no bother. Dr. Fagin's expertise and patient care made this such an easy process for me- it was great to still feel well enough to be able to work from home while I was recovering the first few days after the surgery. I also ended up never needing any of the prescription medication, I found that Advil/Tylenol & ice worked great. I had previously had a consultation with another doctor in Burlingame who was definitely less expensive than Dr. Fagin's office- however after meeting with both I was confident that I made the right decision at my consultation with Dr. Fagin and after such an easy procedure & recovery I'm even happier with my decision. Thank you guys again- cannot recommend enough!!
    Aria Afjei
    Aria Afjei
    1650909896
    My experience with Dr. Fagin was great! The staff at his office were really efficient. The new patient forms were really easy and I didn’t have to wait much time until after I filled them out to get seen by the Dr. Fagin. I had to get my 2nd wisdom tooth out and was anxious that it was going be a painful long operation, but Dr. Fagin was literally an hour process and made me fewl comfortable the whole time. I felt like Dr. Fagin did an excellent job and would recommend him.
    Ivan Ilinsky
    Ivan Ilinsky
    1650662186
    I had an urgent, late-afternoon referral to Dr. Adam Fagin after my dentist had trouble extracting a wisdom tooth. His staff registered me promptly, after which the nurse took my blood pressure and some x-rays. Dr. Fagin showed me the 3D scan of my jaw, explained the situation clearly, and gave me a couple of treatment options. It had been a long day of dental work and I wanted to be done with it - I chose to get the extraction done then and there. I was prepared for another hour of yanking like I had at the dentist, but Dr. Fagin was able to expertly remove the tooth in what felt like 10 minutes, all the while checking on me to make sure I wasn't in pain. At the end of the procedure, he went over what I should expect in the coming days, prescribed some pain medication, and sent me on my way. In the end, my recovery period was much shorter than anticipated.All in all, Dr. Fagin and his staff were very friendly and professional. I would leave 6 stars if I could - highly recommended!
    Nikhil Agashe
    Nikhil Agashe
    1647918051
    Dr Adam Fagin is amazing. I went to him with a complex case, my wisdom tooth extraction was attempted by another dentist and it had broken. I was in a lot of pain. Dr Fagin was able to accommodate me next business day. The surgery was scheduled a day later. He explained me all the options and listened to my concerns. Together we chose the best course forward. I am now recovering well.Thank you for excellent service!!
    I had fractured a tooth just before Christmas and it could not be saved. My dentist called Dr. Fagin’s office and they made sure that they gave me an appointment right away. My tooth was extracted the day before Christmas Eve.My experience was very positive, the doctor was thorough and his staff was so kind to me. They took care of every detail.So grateful!
    Jessica Graham
    Jessica Graham
    1640308588
    Dr. Adam Fagin came highly recommended by my primary dentist for Wisdom teeth removal. Being in my 40's, my lower wisdom teeth were very close to the nerves. Dr. Fagin and his staff answered all of my questions and explained all potential risks. I found him to be personable, knowledgeable, and clear / understandable.I truly appreciated their communication throughout the procedure and keeping me calm through the onset of the anesthesia. I awoke relaxed and felt so comfortable in the warm blanket provided. My recovery has been smooth simply by following the post-op instructions provided (and thanks to the ice cream gift card!).One week later, I visited for a post-op check-in and am feeling so great and having a smooth recovery. I highly recommend Dr. Fagin to anyone looking for a top-notch oral surgeon, especially for wisdom teeth extraction.
    Vanessa Meyer
    Vanessa Meyer
    1640137674
    I was extremely nervous to know that my 2 year old was going to need her tooth pulled that broke from a fall the day before thanksgiving. The stuff in Dr. Adam Fagins office was quick and fantastic on getting us an appointment. On arrival they were kind with check in. We then got taken back to meet Dr. fagin. He explained everything and answered ALL my questions. I felt very comfortable with everything that we discussed so we went ahead and started the removal process right then. I was nervous of course so I talked a lot and he didn’t seem bothered. He was so calm the WHOLE time. Overall this whole experience was better than I prepared for and my 2 year old is on happier than ever.
    francesca viale
    francesca viale
    1638584058
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