Purpose: This article reviews the evolution of outpatient orthognathic
surgery from 1988 to 1995 at the University of Texas Health Science C
enter at San Antonio. Patients and Methods: A total of 328 patients ha
d orthognathic surgery from 1988 to 1995, Two hundred and five (124 fe
males, 81 males) were treated on an outpatient basis in the surgical s
uite of the dental school. Procedures included bilateral sagittal spli
t osteotomies (BSSO), Le Fort I osteotomies (LFI), horizontal mandibul
ar osteotomies (HMO), rapid palatal expansions (RPE), and combinations
of the above. Additional procedures such as submental liposuction, bl
epharoplasty, dorsoseptorhinoplasty, and otoplasty were performed on 2
2 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 observa
tion, and five (2.4 %) were admitted for longer than the 23-hour obser
vation 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 inc
reased dramatically over the study period, The length of anesthesia ti
me, but not the specific procedure, correlated significantly with admi
ssion to observation status, There were few unexpected complications,
with considerable cost reduction and convenience for the patients.