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Pre- and Post-Procedural Instructions for Your CRJ Surgery in West Palm Beach

We at CRJ Institute appreciate the trust you’ve placed in us. Our goal is to ensure you feel prepared, informed, and supported every step of the way. The following guidelines outline what you can expect throughout your hospital stay and early recovery, helping you navigate this critical phase with greater confidence.

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Pre-Operative Instructions

Before undergoing your Comprehensive Reconstruction of the Jaw (CRJ) procedure, it is important to follow these general guidelines to ensure a smooth surgical experience and optimal healing. First, discontinue smoking or using tobacco products at least two weeks before your operation, as tobacco can significantly impair blood flow and slow wound healing. Additionally, avoid nonsteroidal anti-inflammatory medications (NSAIDs), blood thinners, or herbal supplements that may increase bleeding risk, unless otherwise directed by your healthcare team. If you have concerns about any prescribed medications, be sure to discuss them with your surgeon in advance.

We also recommend following standard fasting guidelines: do not consume solid foods or non-clear liquids after midnight on the evening before your surgery. Clear liquids, such as water, should generally be stopped a few hours prior to your procedure as instructed by your anesthesiology team. Arranging reliable transportation to and from the hospital or surgical center is essential, especially if you will be receiving general anesthesia or sedation. Finally, make sure you are up to date with preoperative lab tests and follow any specific instructions provided by your surgeon, such as completing imaging or lab work. By carefully adhering to these recommendations, you can help minimize complications and begin your recovery on the strongest possible footing.

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Your Care Team

During your stay, a multidisciplinary team will guide your recovery and ensure the best possible outcome:

  • Surgery Team (CRJ Surgeons): Oversees your fibula free flap, reconstruction areas, and surgical progress.
  • Medicine Team: Monitors overall health and manages any existing conditions.
  • Physical Therapy (PT) & Occupational Therapy (OT): Helps restore mobility and strength.
  • Speech Therapy: Assists with communication and swallowing as you heal.
  • Nutritional Therapy: Manages dietary needs, including tube feeds and the eventual transition to oral intake.
  • Specialized Nurses: Experienced in caring for patients undergoing complex jaw reconstruction, ensuring consistent support and monitoring.

Day of Surgery

On the morning of your CRJ procedure, you will meet key members of your team in the pre-operative area:

  • Pre-Operative Nurse: Confirms your details, sets up IV access, and prepares you for surgery.
  • Surgeons: Review the plan and answer any last-minute questions before you provide informed consent.
  • Anesthesiologist: Explains general anesthesia and obtains consent.
  • Operating Room Nurse: Manages safety and comfort during the operation.

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Hospital Recovery Timeline

Day 1: Bedrest in ICU

  • Purpose: Protect newly connected blood vessels and minimize movement.
  • Flap Monitoring: Checked hourly to ensure proper blood flow.
  • Pain Management: Scheduled and “as needed” medications for comfort.
  • Nutrition: Continuous tube feeds begin.
  • Other Care: You may have a Foley catheter, temporary tracheostomy, and surgical drains in place.

Day 2: Gradual Increase in Activity (ICU)

  • Activity: Assisted sitting or chair transfers with PT/OT.
  • Flap Monitoring: Blood flow checks every 2 hours.
  • Catheter: Possible removal if you can assist with toileting.
  • Other Devices: Drains, tracheostomy, and feeding tube remain if still necessary.

Day 3: Preparation for Transfer Out of ICU

  • Activity: Walking with PT/OT.
  • Flap Monitoring: Reduced checks to every 4 hours.
  • Surgical Drains: Evaluated for removal once output is minimal.
  • Tracheostomy: May be downsized or capped for speech.

Day 4: Increased Activity (Regular Floor)

  • Activity: Ongoing walking and mobility exercises.
  • Nutrition: Tube feeds transition to bolus feeding.
  • Devices: Drains, tracheostomy, and feeding tube reassessed for possible adjustment.

Day 5: Continued Progress (Regular Floor)

  • Activity: Further walking and strength exercises with PT/OT.
  • Nutrition: Possible oral intake introduction under Speech Therapy supervision.
  • Devices: Ongoing evaluations for removal or modification.

Day 6: Preparation for Discharge

  • Discharge Planning: Assess needs for home health services, supplies, or equipment.
  • Oral Intake: Feeding tube may be removed if you can safely consume >500cc/day by mouth.
  • Tracheostomy: Removal considered if breathing is stable without it.

Days 7–10: Discharge Home

  • Milestones: Stable oral intake, mobility, and wound healing.
  • Transition: You will go home when you meet recovery goals, with a follow-up clinic visit scheduled within 7 days.
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Words From Our Patients "They completely changed my life."

E.M.

Maxillofacial Reconstruction Patient

Both the initial visit and the day of surgery were extremely comfortable. The facility is very clean and tidy. Dr. Guzman and his team were amazing. They were efficient and kind, with a detailed explanation of the entire procedure, which was painless and quite effective. I was very pleased with the entire experience.

A.S.

Maxillofacial Reconstruction Patient

They treated me like family, and their expertise gave me a second chance at life.

R.G.

Maxillofacial Reconstruction Patient

I never thought I’d smile confidently again.Dr. Quimby and her team gave me my life back.

H.B.

Maxillofacial Reconstruction Patient

The level of care and precision here is unmatched. I feel like myself again—stronger than ever.

Read All Testimonials

After Discharge

Strict adherence to post-operative instructions is key to a successful recovery. You’ll have regular follow-up appointments to check healing, evaluate your prosthesis fit, and ensure implant integration.

When to Call Us

Contact [Phone] immediately if you experience any of the following:

  • Fever or chills
  • Shortness of breath
  • Swelling, bleeding, or unusual drainage at the surgical site

Why Choose CRJ Institute?

CRJ Institute specializes in advanced jaw reconstruction, offering world-class surgical expertise within a patient-centric environment. Our board-certified surgeons combine microsurgical excellence, regenerative therapies, and innovative technology—such as virtual surgical planning—to achieve transformative results. By uniting a compassionate care philosophy with a multidisciplinary approach, we provide a streamlined, personalized experience that prioritizes both function and aesthetics. From your initial consultation to post-discharge follow-up, our dedicated team ensures every detail is addressed, helping you feel confident and supported throughout your healing journey.

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Start Your Journey Today Schedule a Consultation

Discover Your Path to Renewed Function, Aesthetics, and Confidence

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