Recently in treatment planning for orthognathic surgery, 3-dimensional analysis using CBCT can give more detailed information that cannot be achieved with 2-dimensional cephalograms. Also, laser Scanning and 3D camera can show 3-dimensional information on soft tissue changes as well as hard tissue changes in orthognathic surgery patients. In other words, soft tissue changes in lateral facial area as well as mid facial area can be quantitatively calculated. To bring out the best results from orthognathic surgery, close interaction between orthodontist and oral surgeon is needed and well treated pre-surgical orthodontics can simplify orthognathic surgical plan that also results in good long-term stability. In surgery-first cases, more thoughtful diagnosis and pre-operative preparation will be needed to prevent complicated problems.