The patient population for elective orthognathic surgery usually comprises young, healthy patients, in whom homologous blood transfusions should be avoided. Homologous transfusion poses substantial, potentially preventable risks to this patient population. In addition to autologous predonation, acute intentional hemodilution is an alternative that potentially aboids the use of homologous blood. Indications and contraindications for its us e as well as initial results in two patients are presented. Furtehr data and experience are required before thi s technique can be recommended for routine use.