Before the start of treatment doctor must be sure that patient expectations are real, similarly, patients must be aware what is real to expect. Patients, who are comfortable with their appearance, and want to improve their occlusion only, might get disappointed by the facial changes which are inevitable after orthognathic surgery.

Keeping in mind that operation may make unattractive faces look better and assist for better integration into social life is probably a realistic expectation, but of course it depends on a specific situation. Facial simulation and model demonstration before the operation might help the patient to understand if the expectations are real and to realize the scope and limits of changes the operation can provide.

Expectation of improving the quality of life after orthognathic surgery must be realistic too. Patients will be satisfied with the postoperative result, if their expectations were average or real, like “I want to feel comfortable in social life”. Patients with unreal expectations like “I want a better success in dating” or “I want to find an ideal wife or get promoted at work”, as a rule, will not be satisfied with postoperative result. All patients presenting high expectations shall be kindly reminded that the modified face will be only a tool that might help achieving their aims of life if manipulated properly.

In general, orthognatic surgery improves physical appearance and self-esteem. Well-planned and well-performed operation may considerably improve psychosocial status. Poorly planned operation, though technically ideally carried out, may end up with big psychological problems for the patient.
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