The concept of orthognathic surgery involves surgical manipulation of facial skeletal elements to restore the anatomy and functional relationships in patients with dentofacial anomalies, and these in turn impacting different functional levels, as phonation, respiration and aesthetics. The complexity of the facial irrigation represents a challenge for the surgical team, in the design of intraoperative management regarding surgical technique, and interventions during surgery, and after it. From the literature review and the medical evidence, in Ovid, PubMed, Cochrane library and management guidelines, which give a comprehensive approach to intraoperative bleeding in patients undergoing orthognathic surgery, reporting changes and postoperative hemoglobin preoperaotoria during the period of July 2014 to July 2015. Key words: Ortognathic surgery, Hemorrhage, Heme, Blood Substitutes Dentofacial Deformities