Outpatient orthognathic surgery: Review of 205 cases

Purpose: This article reviews the evolution of outpatient orthognathic surgery from 1988 to 1995 at the University of Texas Health Science Center at San Antonio. Patients and Methods: A total of 328 patients had orthognathic surgery from 1988 to 1995. Two hundred and five (124 females, 81 males) were treated on an outpatient basis in the surgical suite of the dental school. Procedures included bilateral sagittal split osteotomies (BSSO), Le Fort I osteotomies (LFI), horizontal mandibular osteotomies (HMO), rapid palatal expansions (RPE), and combinations of the above. Additional procedures such as submental liposuction, blepharoplasty, dorsoseptorhinoplasty, and otoplasty were performed on 22 patients. Patient age ranged from 13 to 64 years, (average age 25). Results: Ninety-four (46%) of the patients were discharged the day of surgery. One hundred and two (51%) were admitted for 23-hour observation, and five (2.4%) were admitted for longer than the 23- hour observation period. Anesthesia time over 4:28 significantly correlated with admission for observation status. There was no significant difference between LFI and BSSO in relation to admission for observation status. Conclusions: The number and complexity of orthognathic procedures increased dramatically over the study period. The length of anesthesia time, but not the specific procedure, correlated significantly with admission to observation status. There were few unexpected complications, with considerable cost reduction and convenience for the patients.