Long-term patient satisfaction and complication rates after orthognathic surgery: a minimum 3-year follow-up study

BACKGROUND AND OBJECTIVES: Orthognathic surgery aims to correct dentofacial deformities and improve both function and facial esthetics. This study assessed long-term patient satisfaction and complication rates following bimaxillary orthognathic surgery, using a customized questionnaire to evaluate esthetic, functional, and psychosocial outcomes. MATERIALS AND METHODS: A total of 126 patients who underwent bimaxillary surgery for Class II or III dentofacial deformities were included in this retrospective cohort study with prospectively collected data and evaluated after a minimum follow-up of 3 years. Surgical procedures included Le Fort I osteotomy, bilateral sagittal split osteotomy, multisegmental osteotomies, genioplasty, and SARPE, with all cases planned and managed by an interdisciplinary team. Patient satisfaction was assessed using a 20-item individualized questionnaire based on validated tools (OQLQ, DAS-59, OHIP-14, VAS). RESULTS: High levels of long-term satisfaction were reported, particularly in smile appearance and self-confidence. Smile-specific satisfaction remained stable regardless of skeletal class, gender, or complications. Postoperative complications occurred in 11.1% of patients and represented the main observed factor significantly associated with reduced overall satisfaction (p < 0.001). The most frequent complications included mandibular plate infection (n = 5), mandibular osteoperiostitis (n = 4), plate detachment (n = 2), plate fracture (n = 1), pseudoarthrosis (n = 1), and malunion with vicious callus (n = 1). All were successfully managed without long-term sequelae. CONCLUSIONS: Orthognathic surgery provides consistent long-term esthetic and psychosocial benefits. Individualized planning, interdisciplinary management, and the use of a customized satisfaction questionnaire may have contributed to the favorable patient-reported outcomes observed. These findings support the role of orthognathic surgery in enhancing quality of life beyond skeletal correction.