Patients are often surprised to hear that occlusal restoration may not be effective without orthognathic treatment – why? Less doubts and astonishment are expressed by those who have a big lower jaw. Most frequently those people are more concerned about their physical appearance and welcome every possibility to change facial shape. Those with insufficiently developed lower jaw quite often look stunned. „What is wrong with my face? Why do I need surgery? I came here for my teeth!“ – it is the first thought that comes to the mind of those people. Smaller lower jaw is usually perceived as fairly aesthetic and only marked deficiency of the lower jaw is highly noticed.

People who are actively seeking for professional help usually have rich negative experience through many unpleasant situations because of their appearance. Intensive growth of the lower jaw turns visible when a child is 12-13 years old – at the age of adolescence, when insults and tease from peers may have influence on personality development. Personality structure is formed in adolescence, therefore psychological traumas seldom go away without consequences. Although orthognathic surgery performed in adulthood is expected to compensate for bad childhood memories, unfortunately a deep scar is left in their psychological development and people stay sensitive to their appearance for the rest of the life. Feelings from the past, like shame, fear to be rejected, despair, sadness, and anxiety – fades away after the surgery but it comes back again during stressful moments. Some people wait for the surgery like for the breath of air, and after the surgery they usually feel like born again. Others expect more than a surgeon can give – to boost their self-esteem or find new friends. Sometimes a wish to become more attractive for the opposite sex and find a life-time partner is the only motivation for surgery. But such people usually have more serious psychological problems – interpersonal communication problems, hypersensitivity to criticism, family problems with parent s or spouse. A belief that everything comes along with attractive physical appearance inevitably leads to failure.

Today physical attractiveness, especially facial attractiveness, plays a representative role. Life is dynamic, we communicate with many people, and we tend to evaluate others by their appearance. Our appearance is more than emotionless picture. It reveals or masks our emotional struggle, conflicts and other experiences. Facial mimics is an additional form of communication. Even a beautiful person may look repelling if his/her soul is filled with anger or hatred because of emotionally painful experiences in the past. It is hard to control our facial expressions, and although adults can do that pretty well, attentive eye can catch it when body language tells truth and when it lies because artificial facial expressions are asymmetrical and less intensive.

It is an art and a hard work at the same time to be friends with your own body and to accept your physical imperfection even after surgery. The preparation period before surgery is long and tormenting, obviously the recovery can’t be miraculously fast. Orthognathic treatment requires a lot of physical tenacity, sometimes even physical suffering. After surgery many patients suddenly realize how unfortunate they were in the past and it results in the feeling of sadness. Patients need to learn to accept and perceive their new faces. Not earlier than when the patient makes friends with his/her face again, the face can become a powerful tool in meeting the goals that were unachievable before surgery.

Support from close friends is extremely important during the entire orthognathic treatment period. If close people do not wish to understand the struggles of the patient or if they do not approve surgical treatment, then the person is left alone with his/her fight for a more attractive appearance. Loneliness and a lack of support from peers negatively affect the treatment and sometimes even cause more dissatisfaction with new appearance from a patient. In such a case the surgeon receives more critics, although the real reason for dissatisfaction is negative emotional experience caused by indifference from surrounding people.

Those who strongly make up their minds and strive for surgery often demand from life more than they have at the moment. Usually they are people who do not want to accept limitations and believe in modern medicine’s achievements. According to the Bible, for some a wish to find harmony in this life and not after death is so strong, that these people do not limit themselves within the body, they also care about their souls. At this point psychology might come to help..