Treatment of any type cannot be performed without risk of complication. However, regardless of the treatment option chosen, the goal should be to provide maximum benefit with minimal risk. Accordingly, surgery is indicated for those patients seeking changes in aesthetics and function of a magnitude not possible with orthodontics alone. Careful planning and good communication are paramount to avoiding many complications. Current technology allows clinicians to simulate treatment and plan for optimum aesthetics and function while involving patients and significant others in the decision making process. This technology now is the state of the art, and it soon may be considered the standard of care. Patient education and feedback should be an integral part of the decision-making process when more than one option is available; this minimizes surprises and the chance of patients and family viewing an expected consequence of treatment as a complication. When a true complication occurs, early recognition, rapid response, and effective resolution are essential.