Learning curve in minimally invasive orthognathic surgery

Minimally invasive orthognathic surgery (MIOS) offers numerous advantages, including reduced morbidity, faster recovery, and better aesthetic outcomes compared to conventional methods. However, the learning curve associated with MIOS has not been well studied. This study aims to evaluate the learning curve associated with MIOS. A consecutive series of 30 bimaxillary orthognathic surgeries (30 patients), including genioplasty, was performed by a single surgeon, using the minimally invasive approach. Surgical time, intraoperative blood loss, and incision sizes were measured. All surgeries followed the described MIOS protocol. The learning curve for MIOS was evident in the first 12 cases, where surgical time, bleeding, and incision sizes improved significantly. Incision lengths in the maxillary approach increased significantly (*p < 0.05), while a significant (*p < 0.05) reduction in genioplasty incision size was observed. Four reoperations were required. Six major complications were reported, with most occurring during the initial 10 cases. Complications decreased after the initial cases, reflecting the surgeon's increasing proficiency. Compared with conventional surgery, MIOS showed a significant reduction in blood loss and duration of hospital stay, therefore, MIOS appears to be a safe, feasible and effective technique. However, further research is needed to confirm these findings and establish standardised MIOS protocols.