As part of your treatment, you will meet orthognathic surgeons, orthodontists and psychologists and you’ll be asked to complete our questionnaire. Someone from our team may come and speak to you during one or your clinic appointments.

If you agree to a referral to our service, we will be in touch to offer you an appointment to explore in more depth your concerns and your broader circumstances, to understand anything which may be affecting your orthognathic treatment and how your orthognathic treatment may impact you.

This initial appointment allows us to think about whether our service can offer you some support to help you along your orthognathic journey and enables us to consider with you and your medical team whether orthognathic treatment is suitable and safe for you at this time.  

Possible outcomes 

After your first appointment it is often helpful for us to discuss next steps for your care as a team, therefore we will agree a time to get back in touch with you to discuss this, usually within two weeks of your appointment.

• There are a few possible outcomes from an initial appointment with the Orthognathic Psychology Service, including:
• Being added to our waiting list for 1:1 psychological therapy.
• Being signposted or referred to another mental health service that is more suitable for the support you need (we would do this jointly with you, with your consent)
• We may also agree that you don’t want or need any support with us at this time, in which case you’ll be discharged from our service. 

Pre-Surgery Advice from Psychology

1. Understanding the Journey Ahead and Managing Expectations

• Set realistic expectations: Surgery can bring physical changes and emotional adjustments. Take time to understand the likely outcomes and challenges associated with your treatment.
• Ask your surgeon and team for clear explanations about the procedure, recovery timeline, and expected results. No question is too small. Feeling informed can reduce anxiety and uncertainty.
• Expect uncertainty on the day: you may go through to surgery quickly, however some people find they have some time waiting around beforehand. You are likely to be seen by a number of medical professionals in preparation for the surgery, and this can feel a bit overwhelming for some.  As your medical team will explain, there is always a small chance of a last-minute cancellation due to unforeseen circumstances beyond their control. Understandably, a last-minute cancellation can be frustrating and distressing; be assured that if this were to arise then the team will do their best to reschedule quickly.

2. Managing Pre-Surgery Anxiety

• It’s normal to feel anxious before a planned surgery or procedure. If you are feeling worried or anxious, there are some techniques or tips that can help you feel more relaxed:
• Practice relaxation techniques (see additional anxiety resources): Deep breathing, progressive muscle relaxation, or mindfulness exercises can help reduce stress. Simple breathing technique: Inhale deeply through your nose for a count of four, hold the breath for four, then exhale slowly through your mouth for a count of four, then hold for a count of four.
• Try progressively tensing and relaxing your muscles, starting from your feet. Tense your toes for a few moments, notice the sensation, then relax. Continue working your way up your body, tensing and relaxing each muscle group, until you reach your face and jaw.
• Visualise success: Imagine the surgery going smoothly and visualise yourself recovering comfortably afterward. This mental rehearsal can help reduce anxiety and promote a sense of control. You can also visualise how things will look and feel in the future, when you are healed and have finished your treatment; focusing on the positive outcomes as opposed to your concerns or immediate worries can help you to reframe the situation.
• Feeling prepared for the surgery and planning for the recovery period can help ease some anxiety. It can be helpful to write a list of the things you are worried about (e.g. coping with pain, managing your fluid diet, childcare or planned leave, discussing the surgery with friends or colleagues), and brainstorming practical solutions to address these concerns.
• Talk it out: Share your concerns with the orthognathic team, friends, or family.

3. Preparing Emotionally for Change

• Adjusting to appearance changes: Surgery may impact how you feel about your appearance. Prepare to take time to adapt and remember it takes time to heal and for your face to settle after surgery.
• Sometimes it is tempting to scrutinise your face after surgery and check in the mirror frequently, which can be unhelpful as it magnifies any existing concerns and creates concerns that we would not have if not looking in the mirror so much. Recovery is a journey, and it is good to trust the process and try not to make judgements until you are full healed.
• Prepare for mixed emotions: It’s normal to feel excited, nervous, or uncertain. Journaling your thoughts may help.
• Focus on the bigger picture: Remember why you’re doing this whether it’s for better functionality, health, or confidence.
• The orthognathic psychology team is here to help. Reach out for support if you feel overwhelmed regarding treatment or have concerns about surgery or recovery.

4. Building Your Support Network

• Support network: Try to surround yourself with supportive friends or family members who can provide emotional comfort and encouragement before and after the surgery.
• Consider seeking a local or online support group: Some people find it helpful to connect with others who have undergone similar surgeries can provide reassurance and tips.

5. Coping with Recovery Challenges

• Prepare for discomfort: Recovery takes time, and you might experience swelling, bruising, or temporary difficulty speaking or eating.
• Celebrate small milestones: Acknowledge progress, even small steps, during recovery.
• Some people find that understanding more about the procedure and what will happen helps relieve worry. Work out what level of information is best for you – some people prefer to keep it simple and short, however if you would like more details, you can ask the medical team or find additional resources online at https://bos.org.uk/patients/treatments/your-jaw-surgery

Appearance Concerns

Website aimed at people living with visible differences, however, offers useful advice about:

• Confidence and self-esteem relating to appearance
• Emotional wellbeing 

The following website offers some support for those struggling with appearance-related distress, including comprehensive advice and resources on how to improve low self-esteem:  Appearance Overconcern Self-Help Resources - Information Sheets, Worksheets & Workbooks

Anxiety Resources

https://www.dentalphobia.co.uk/

https://www.oxfordmindfulness.org/learn-mindfulness/resources/

Preparing your mind before surgery | The Royal College of Anaesthetists

Script-Mindful-Breathing.pdf

Progressive Muscle Relaxation

Additional Resources Related to your Surgery 

You can watch some informational videos on what your procedure entails and hear about patient journeys here: Your Jaw Surgery - British Orthodontic Society (BOS)

If you would like some support for your mental health, you can speak to your GP for advice about the most appropriate service for your concerns.

The NHS also offers talking therapies for free to individuals struggling with their mental health. Talking therapies, or psychological therapies, are effective and confidential treatments delivered by fully trained and accredited NHS practitioners. They can help if you're struggling with experiences such as symptoms of low mood, excessive worry, social anxiety or post-traumatic stress disorder (PTSD) as well as other mental health difficulties.

You can refer yourself directly to an NHS talking therapies service without a referral from a GP, or a GP can refer you. Help is available in person, by video, over the phone or as an online course.

You can find out more or find your local talking therapies service here: NHS talking therapies for anxiety and depression - NHS

You can also find some advice and practical self-help tips to improve your wellbeing here  Every Mind Matters - NHS