Dentofacial deformity refers to deviations from normal facial proportions and dental relationships that are severe enough to be handicapping. Treatment of any type cannot be performed without risk of complication. However, regardless of the treatment option chosen, the goal should be to provide maximum benefit with minimal risk. Accordingly, surgery is indicated for those patients seeking changes in aesthetics and function of a magnitude not possible with orthodontics alone. Careful planning and good communication are paramount to avoiding many complications. Current technology allows clinicians to simulate treatment and plan for optimum aesthetics and function while involving patients and significant others in the decision making process. In modern practice, surgical treatment for dentofacial deformity consists of both orthognathic procedures to correct jaw relationships and adjunctive procedures to correct hard and soft tissue contours.