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Today's orthodontist has many treatment options to choose from in reaching goals of treatment. Virtually all of these treatment options are designed to reach the same general orthodontic treatment goal that is class I occlusion with good facial esthetics. However each treatment choice almost always has an effect on the face and facial cosmetics. This is very true with orthodontic treatment and may be even more dramatic with combined orthodontic and orthognathic surgical cases. For example in a camouflage treatment of class II mandibular deficiency over retraction of maxillary anteriors to achieve normal Overjet will result in "dished profile". This will have an unpleasing effect on the profile and facial esthetics. I the area of orthognathic surgery, impaction of the maxilla to correct an open bite may result in unacceptable widening of the base of the nose. In the area of facial cosmetic surgery, camouflage of mandibular deficiency with an implant may result in a "witch's bob".