In short: Minimally invasive orthognathic surgery (MIOS) reduces muscle and soft-tissue dissection to the minimum necessary, which translates into less bleeding and less swelling. Combined with 3D planning and an ERAS anaesthesia protocol, what traditionally meant months of readaptation translates, in our team's experience, into 3 to 4 weeks until you're back to your usual rhythm of life. It isn't a universal promise.
For years, orthognathic surgery has dragged along a reputation that doesn't do it justice: months of recovery, a very swollen face, weeks unable to speak or eat normally. That image reflects how this surgery used to be done, not how it can be done today. At ARQÉA we work with an evolved approach to this surgery, brought together under the concept of MIOS (minimally invasive orthognathic surgery), which is also part of what we teach at MIOS Academy, the training project we drive to bring these techniques to residents and surgeons who want to take their practice a step further.
What really changes with the minimally invasive approach
Conventional orthognathic surgery involves wide dissection of the muscles and soft tissues to reach the bone. The more dissection, the more bleeding, the more swelling and the more time the body needs to recover. The MIOS approach aims to reduce that dissection to the minimum necessary, preserving muscle attachments and blood supply whenever the technique allows.
The difference isn't cosmetic: less muscle dissection translates into less intraoperative bleeding, less postoperative swelling and, in our experience accumulated over more than a decade and several hundred operated patients, into more favourable bone and soft-tissue healing. That's what makes it possible to shorten recovery without compromising the precision of the result.
3D planning: every case, made to measure
One of the pillars of this approach is three-dimensional virtual planning. Before entering the theatre, the case is designed digitally: the exact bone movement to be performed is defined, in all three planes of space, on the patient's own 3D model.
That planning is then translated into 3D-printed cutting guides and osteosynthesis plates, custom-made for each case. The result is a surgery that reproduces in theatre, with high fidelity, what was designed beforehand on the computer, reducing the margin for intraoperative improvisation and, with it, the risk associated with on-the-fly adjustments.
The ERAS protocol: how the patient wakes up matters too
The surgical part isn't the only one we've rethought. We follow an ERAS (Enhanced Recovery After Surgery) anaesthesia protocol, aimed at improving the patient's comfort before, during and after the operation, from pain management to postoperative nausea, two of the factors that most shape how the first week after surgery feels.
From months to weeks: what this means for the patient
With this combination (minimally invasive approach, 3D planning and ERAS protocol), what traditionally meant months of readaptation translates, in our team's accumulated experience, into a process of 3 to 4 weeks until you're back to your usual rhythm of life. It isn't a universal promise, since every patient and every type of bone movement has its own recovery curve, but it does reflect what we've observed consistently in clinical practice.
In favourable cases, this means speaking, eating progressively and walking normally from the first days, without the prolonged restrictions that for years have been associated with this surgery.
More options, not a single path
Evolved orthognathic surgery isn't just the surgical part: it also means rethinking how it coordinates with orthodontics. We work with surgery first, surgery early or surgery only protocols, as each case allows, and adapt the type of orthodontics (from no prior orthodontics at all to aligners, aesthetic or conventional braces) to each patient's needs and rhythm of life, instead of imposing a single protocol on everyone. And not everything you notice in your smile needs orthognathic surgery: in a gummy smile, for example, the bone is only one of four possible causes.
Why we teach it, as well as practise it
This approach isn't born of theory: it rests on more than ten years of practice and several hundred cases. That's why, beyond applying it at ARQÉA, we share it through MIOS Academy, with the goal that these techniques, today available in very few centres in Spain, reach more surgeons and, through them, more patients.
If you're considering orthognathic surgery and want to know whether your case is a candidate for a minimally invasive approach, we can assess it at a consultation with your personalized 3D plan.
Frequently asked questions
How long is recovery after minimally invasive orthognathic surgery?
In our team's accumulated experience, 3 to 4 weeks until you're back to your usual rhythm of life, and in favourable cases you can speak, eat progressively and walk normally from the first days. It isn't a universal promise, since every patient and every type of bone movement has its own recovery curve.
What is the difference between minimally invasive and conventional orthognathic surgery?
Conventional orthognathic surgery involves wide dissection of the muscles and soft tissues to reach the bone. The MIOS approach aims to reduce that dissection to the minimum necessary, preserving muscle attachments and blood supply whenever the technique allows.
Is there less swelling with minimally invasive orthognathic surgery?
Less muscle dissection translates into less intraoperative bleeding, less postoperative swelling and, in our experience, more favourable bone and soft-tissue healing.
How is 3D planning used in orthognathic surgery?
Before entering the theatre, the exact bone movement is defined digitally, in all three planes of space, on the patient's own 3D model. That planning is translated into 3D-printed cutting guides and osteosynthesis plates, custom-made for each case.
What is the ERAS protocol?
ERAS (Enhanced Recovery After Surgery) is an anaesthesia protocol aimed at improving the patient's comfort before, during and after the operation, from pain management to postoperative nausea.
Do I need orthodontics before orthognathic surgery?
Not always. We work with surgery first, surgery early or surgery only protocols, as each case allows, and adapt the type of orthodontics (from no prior orthodontics at all to aligners, aesthetic or conventional braces) to each patient's needs.
How much does orthognathic surgery cost at ARQÉA?
Single-jaw orthognathic surgery costs €6,500 and bimaxillary surgery €12,000, with general anaesthesia and the surgical centre included. You can estimate your quote with our price calculator; the final quote is confirmed in writing after your consultation.
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