A 34-year-old woman with mandibular micrognathia, vertical maxillary excess, and an open bite characterized by a "bird-face" deformity was treated with orthodontics combined with LeFort I and bilateral inverted L osteotomies. The total treatment time was 16 months. Her occlusion and facial appearance were significantly improved by a surgical-orthodontic plan. This case report presents the discussion of a unique and complex orthognathic surgical case and the myriad of orthodontic and surgical considerations that it involved.
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