Orthofacial surgery has evolved toward more precise, less invasive, and patient-centered models. In this context, LIOS (Low Impact Orthofacial Surgery) emerges as a comprehensive philosophy developed under the direction of Prof. Federico Hernández-Alfaro, redefining how orthognathic surgery is planned and experienced.
LIOS is not a single surgical technique. It is an integrated treatment approach designed to reduce the overall physical, functional, and emotional impact of surgery.
What Is LIOS?
LIOS stands for Low Impact Orthofacial Surgery. The concept, developed within the clinical and academic environment of Instituto Maxilofacial, is built on three fundamental pillars:
Advanced diagnosis and digital planning
Minimally invasive surgery coordinated with orthodontics
Early recovery after surgery (ERAS protocols)
The objective is clear: maximize outcomes while minimizing the global impact of treatment.
Digital Planning and Surgical Precision
The first pillar is comprehensive facial diagnosis supported by advanced 3D digital planning. Before entering the operating room, surgery is virtually simulated to determine the precise final position of facial structures.
This approach allows for:
-
Greater surgical predictability
-
Reduced risk
-
Improved patient communication
-
More stable long-term results
In the model promoted by Prof. Hernández-Alfaro, low-impact surgery begins long before the actual procedure.
Minimally Invasive Surgery and Orthodontic Coordination
The second pillar integrates scientifically developed and published surgical techniques known as the Barcelona Protocol for Minimally Invasive Orthofacial Surgery.
These techniques aim to reduce:
-
Surgical trauma
-
Blood loss
-
Postoperative swelling
-
Recovery time
However, LIOS emphasizes a key element: proper pre- and post-surgical orthodontic management is essential for long-term stability and optimal functional results. Orthognathic surgery is understood as a multidisciplinary process.
Early Recovery and the Patient Experience
The third pillar incorporates ERAS (Early Recovery After Surgery) protocols to optimize the entire perioperative process.
This includes:
-
Preoperative nutritional preparation
-
Advanced anesthetic protocols
-
Intraoperative pain control
-
Cryotherapy and early physiotherapy
-
Lymphatic drainage
-
Psychological support
This structured approach reduces pain, swelling, and anxiety, significantly improving the overall patient experience.
A New Paradigm in Orthognathic Surgery
The LIOS philosophy, developed under the direction of Prof. Federico Hernández-Alfaro, represents a shift from a purely technique-focused surgery to a model centered on the patient’s complete experience.
As medicine moves toward personalized, evidence-based, and less invasive treatments, Low Impact Orthofacial Surgery reflects the natural evolution of modern orthofacial surgery.
Frequently Asked Questions About LIOS
What is LIOS in orthofacial surgery?
LIOS stands for Low Impact Orthofacial Surgery. It is a comprehensive treatment philosophy that integrates advanced 3D digital planning, minimally invasive surgical techniques, coordinated orthodontic management, and early recovery protocols to reduce the overall impact of orthognathic surgery on the patient.
Who developed the LIOS concept?
The LIOS concept was developed under the direction of Prof. Federico Hernández-Alfaro, an internationally recognized specialist in orthognathic and maxillofacial surgery.
How is LIOS different from traditional orthognathic surgery?
Traditional orthognathic surgery focuses primarily on correcting skeletal discrepancies. LIOS goes further by addressing the entire treatment journey — including diagnosis, digital simulation, minimally invasive techniques, orthodontic coordination, psychological preparation, and structured postoperative recovery.
The emphasis is not only on surgical precision but also on improving patient experience and recovery.
What are the main pillars of Low Impact Orthofacial Surgery?
LIOS is based on three fundamental pillars:
Advanced facial diagnosis and 3D digital planning
Minimally invasive surgical and orthodontic protocols
ERAS (Early Recovery After Surgery) principles
Together, these elements aim to enhance predictability, reduce complications, and accelerate recovery.
Where is the LIOS philosophy applied?
The LIOS approach is implemented within the clinical and academic framework of Instituto Maxilofacial and is presented in international congresses and professional forums dedicated to orthofacial surgery.
Is LIOS suitable for all orthognathic surgery patients?
LIOS is a treatment philosophy rather than a specific technique, meaning its principles can be adapted to a wide range of orthognathic cases. However, individual suitability depends on a comprehensive clinical evaluation and personalized treatment planning.
