Eating enough calories and protein are both key to nourishing your body during recovery, maintaining your weight, and preventing against excessive muscle loss.
A lot of patients are excited at the prospect of losing weight after jaw surgery, but please be careful! Under-eating post-op can not only comprise the healing process, but it also puts you at risk for losing muscle, which in turn will lower your metabolism among other things! If you want to lose weight after your jaw surgery, I strongly encourage you to consider working with a dietitian to do so safely.
Ok, so back to our question...
HOW MUCH should you be eating after jaw surgery?
Here are 3 ways to determine how much to eat:
Rely on your hunger cues.
Estimate your calories and protein off of 3 days of normal pre-op eating.
Use an energy equation and protein equation to estimate your needs.
I recommend doing a combination of all 3, while weighing yourself daily to make sure you're on track.
Here is an example of how these 3 indicators went for me...
My hunger didn't come back until day 6 post-op, so this was NOT a reliable indicator until after the first week.
Before my surgery, I logged 2 normal week-days and 1 normal weekend day of eating in a free food app (MyFitnessPal). The result? Around 2050 calories/day. TIP - Don't forget to include everything you drink too! Liquid calories also add up.
I used the Mifflin St Jeor energy equation to estimate my calories needs. This equation uses your sex, height, weight, age, an activity factor, and a stress factor to estimate how many calories you burn per day. You can easily find a Mifflin St Jeor formula calculator online. My result? Around 1900 calories/day, which was pretty close to my results from logging my food. For protein, my goal was 1.2 grams of protein/kg body weight (which is a typical recommendation for post-surgical patients and I personally prefer a higher protein diet), or 75 grams protein/day.
So to summarize, my post-op eating goals were...
Around 1900-2050 calories/day
Around 75 grams of protein/day
1.5-2.0 L liquid/day to stay hydrated (including liquid food)
To achieve this, I planned to aim for...
3 meals + 3-5 snacks (or basically eating every 2 hours)
Meals of = 350-500 calories and 15-30 grams of protein
Snacks of = 200 calories and 8-15 grams of protein
NOTE: The goals above are tailored to my needs and my health profile. I'm sharing these numbers as an example only, not for you to copy. For tailored nutrition advice, always consult with a registered dietitian. Also note that the energy and protein equations I used assume you are in good health. Check with a registered dietitian before using them.
REALITY CHECK!
In the days post-op I was NO WHERE CLOSE to achieving these goals. Despite sipping on liquids constantly in the hours I was awake, I was averaging 30-50 mLs (or only 2-3 tbsps!) per 10-15 minutes. It was super discouraging swallowing 3 mLs at a time with the syringe, but I was persistent. The good news is that it gets better with each day that passes.
I'd say that the first 5 days of eating were the worst. Nothing is appetizing, you're not hungry, it's painfully slow, half the liquid is dribbling out of your mouth and you can't seem to grab paper towels fast enough, your mouth is numb and incredibly swollen, you can't find your lips without a mirror, everything is sore when you swallow, etc.
If you're in the trenches right now, my best advice is to simply focus on doing your best, take it 3 mL at a time, and pause for breaks when you feel frustrated.
When was I actually able to hit my nutrition goals?
By day 5 or 6 post-op I was reaching my goals. It took a lot of discipline to force myself to eat basically every 1-2 hours, but it was important to me. I also think that tracking what I was eating was super helpful. It reminded me that every mL and 100 calories adds up over the course of a day.
What next?
I tracked my food and weighed myself religiously for the first 10 days. After the first week and a half I found I was eating the same things, mostly relying on my hunger to remind myself to eat, and I was happy with my weight, so I stopped my detailed tracking.
I'm currently 19 days post-op and still on liquids. I weighed myself today and realized I've lost 2 lbs in the last 5 days, so my plan is to start tracking again. It's easy to become lax when eating and drinking is a chore. Despite being a dietitian, I don't enjoy tracking my food, but to optimize my recovery, I know it's important to stay accountable.
All my best,
Monica, the Jaw Surgery Dietitian
P.S. Are you Canadian? Cool, me too! If you're looking for additional food and nutrition support in your journey and you're a resident of one of the following provinces, feel free to reach out for an online appointment. I'm able to work with patients in Quebec, Ontario, Saskatchewan, Manitoba, New Brunswick, Nova Scotia, and Newfoundland and Labrador. Contact me here!
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