Patient satisfaction in orthognathic surgery and the role of expectations

Orthognathic surgery (OGS) corrects dentofacial deformities and can substantially improve quality of life (QoL). How satisfaction relates to patients' preoperative expectations, surgical magnitude, and demographics remains a subject of debate. Our single-centre retrospective study included consecutive OGS patients with ≥ 6-month follow-up and completed PROMs. Validated instruments comprised the Orthognathic Quality of Life Questionnaire (OQLQ) and selected FACE-Q scales; global satisfaction was rated on a 0-10 VAS. Primary endpoints were postoperative satisfaction and change in QoL. The cohort comprised 290 patients (176 women, 114 men, mean age 23.4 years); 42% underwent single-jaw and 58% bimaxillary surgery. At a mean 12.2-month follow-up, satisfaction was high (VAS 9.1 ± 1.1), with 93.8% reporting that treatment met or exceeded expectations. OQLQ improved from 42.5 ± 17.3 preoperatively to 15.4 ± 12.1 postoperatively (p < 0.0001), with gains across domains; FACE-Q scores were similarly high. Satisfaction did not differ by surgery type (VAS 9.0 ± 1.2 vs 9.2 ± 1.0; p = 0.34), expectation focus (ANOVA p = 0.67), sex (p = 0.42), or age (ρ = -0.05; p = 0.37). OGS yields large QoL gains and very high satisfaction. When treatment plans address the patient's chief concern, satisfaction is independent of surgery magnitude, expectation focus, sex, and age. Structured preoperative counseling, paired with routine PROM monitoring, may help align expectations with achievable outcomes, and support optimal patient-centered results.