Thanks to the increasing ease of information accessibility, it’s not uncommon that patient came and required “I need facial bone contouring surgery”. After thorough consulting process and delving into the details, he realized that in addition to the chief complaint of square face deformity, he also concerned about his profile concavity, sunken midface and the way he smiled. Therefore we customized a combination treatment plan that not only address the square face problem but also optimize patient’s smile arc and profile concavity. Surgical procedures included clockwise rotating orthognathic surgery, lower jaw angle contouring surgery and reduction malar-plasty all in one operation. We simulated the result of facial contouring surgery only “WITHOUT” orthognathic surgery (patient’s initial thought) so that we can understand the aesthetic benefit of adding rotation orthognathic surgery to facial contouring surgery. I personally think the key difference is the overall improvement of a person’s temperament in orthognathic surgery group.