Instituto Maxilofacial
Prof. Federico Hernández Alfaro, Full Professor, MD, DDS, PhD, FEBOMS
International opinion leader and worldwide lecturer
Author of three books
More than 500 lectures in international conferences and congresses
Member of prestigious boards around the world
Orthognathic surgery, derives from the Greek words orthos, meaning “straight” and gnathos, meaning “jaw”, is a surgical intervention aimed at correcting dento-cranio-maxillofacial deformities in order to achieve the perfect balance amongst all of the patient’s facial features. These facial alterations appear during the age of growth and are stabilized upon its completion.
Since all these components form an indivisible whole, the maxillofacial surgeon must also jointly assess the morphology and the function. Therefore, when aiming to harmonize the face, the entire dento-cranio-maxillofacial complex, with its various aesthetic and functional elements, must be assessed holistically. The professionals at the Maxillofacial Institute consider functionality and aesthetics as a whole.
Orthodontics and Orthognathic Surgery
Orthognathic surgery is closely tied in with orthodontics. Therefore, correcting dento-cranio-maxillofacial deformities always involves teamwork between the orthodontist and the maxillofacial surgeon.
In the conventional treatment scheme, orthodontics-orthognathic surgery-orthodontics, the aim of pre-surgery orthodontics is to eliminate any existing dental compensation and to provide the surgeon with a stable and adequate structure between the upper and lower arches in order to be able to carry out the planned skeletal movements. Post-surgery orthodontic treatment is essential for establishing the adequate final occlusion.
The maxillofacial surgeons at the Maxillofacial Institute work together with the best orthodontists in the country. During the treatment of any patient suitable for orthognathic surgery, both the maxillofacial surgeon and the orthodontist ensure that they know the essential aspects of diagnosis and treatment. They must also fully agree on the proposed treatment and the way it should be carried out so that the patient is fully confident all the time of accepting it.
Prof Federico Hernández Alfaro and his team have created protocols that allow certain orthognathic surgery procedures, such as orthognathic surgery for mandibular advancement, SARPE (Surgically Assisted Rapid Palatal Expansion), and mentoplasty, to be performed under local anesthetic and sedation, without requiring hospital admission.
Patients can go home within two hours after surgery, which lasts an average of 30 minutes. The patient’s post-surgery experience is dramatically improved in comparison to the conventional technique, which is carried out under general anesthesia and which requires hospitalization: the total surgery time is significantly reduced, surgical trauma is non-existent and recovery is immediate.
The Maxillofacial Institute is the only centre in Spain to perform this technique and it is one of two centers in the world that practices it. Prof. Hernández Alfaro explains it in his two articles published in 2002 and 2010 respectively: The sagittal mandibular osteotomy under local anesthesia and intravenous sedation: Four years of multi-center experience and Minimally Invasive Surgically Assisted Rapid Palatal Expansion with Limited Approach Under Sedation: A Report of 283 Consecutive Cases.
