Major complications and 30-day morbidity for single jaw versus bimaxillary orthognathic surgery as reported by NSQIP

Jonathan Bacos, Sergey Y. Turin, Elbert E. Vaca, Arun K. Gosain*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective: Acute complications in orthognathic surgery are reported in single-institution studies with small sample sizes. We aimed to analyze risk factors for acute complications using a national data set to better inform surgical decision-making. Methods: 2005-2015 National Surgical Quality Improvement Program (NSQIP) data sets were analyzed for patients undergoing Le Fort 1 and/or bilateral sagittal split osteotomies (BSSO) for nontraumatic indications. Demographics, comorbidities, medical, and surgical 30-day complications were tabulated. A logistic regression model was used to determine predictors of complications. Results: Five hundred eight patients met the inclusion criteria: 228 underwent Le Fort I osteotomies, 152 BSSO, and 128 patients underwent both during a single surgical encounter. Overall complication rate was 4.5% (23/508). Superficial infection was the most common complication (11 in BSSO and 2 in Le Fort I cohorts). Increasing age and undergoing BSSO alone were associated with higher overall complication rates (P < .05) and surgical complications specifically (P < .05). Patients undergoing the combined procedure had shorter operative time (208 minutes) than the times for Le Fort I osteotomies alone (177 minutes) and BSSO alone (155 minutes) added together and did not have a longer hospital stay (P = .608) or increased need for transfusion (P = 1.0) compared to the surgeries being done separately. Conclusion: This is the first complication risk factor analysis for Le Fort I osteotomy and BSSO using the multi-institutional NSQIP data set. Combining BSSO and Le Fort I osteotomy leads to a shorter overall operative time and does not increase hospital stay duration or 30-day complication rate when compared to the 2 procedures being done separately.

Original languageEnglish (US)
Pages (from-to)705-710
Number of pages6
JournalCleft Palate-Craniofacial Journal
Issue number6
StatePublished - Jul 2019
Externally publishedYes


  • Dental occlusion
  • Esthetics
  • Facial morphology
  • Mandible
  • Maxilla
  • Orthognathic surgery
  • Surgical technique

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology


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