Excessive blood loss is one of the major complications of orthognathic surgery. Numerous strategies, including hypotensive anesthetic techniques and blood transfusion, have been developed to deal with the blood loss. Blood for transfusions can be obtained from banked blood or from autologous donation. In this study, the authors looked at 2 groups of patients who had bimaxillary orthognathic surgery. One group included patients who had autodonated blood (group 1) and who were operated on between 1991 and 1993, and the other patients did not autodonate and were operated on between 1998 and 2000 (group 2). It was found that fewer than 50% of patients in group 1 were transfused, and none of the group 2 patients were. A protocol to lessen blood loss that should obviate the need for blood transfusion is proposed. It is concluded that blood transfusion should no longer be a consideration during routine bimaxillary orthognathic surgery.