Aesthetics of facial skeletal surgery.

Orthognathic surgical planning should derive primarily from aesthetic considerations, and these should be based not on rigid cephalometric and anthropometric norms but on the surgeon's aesthetic sense. The historic goals of orthognathic surgery have addressed both stability and aesthetics. Stability relates to establishing a healthy, functional occlusion; aesthetic goals have focused on normalizing facial balance and proportions. With the advent of rigid fixation and bone graft substitutes, sacrificing facial aesthetics to attain stability and achieve a normal occlusion is no longer necessary. Orthognathic surgery now can be envisioned truly as aesthetic surgery.