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Surgical correction of the maxillofacial skeletal deformity is to restore normal Esthetic and function, while minimizing potential
negative short-term and long-term sequelae. The surgical correction of maxillofacial skeletal deformities includes the reconstructive
procedures that correct deformities of the maxilla, mandible; facial skeleton and associated soft tissue structures. The etiology of
maxillofacial skeletal deformities may be either congenital or acquired. Deformities may be evident at birth or may manifest during
subsequent growth and development, creating functional, degenerative, cosmetic and/or psychological problems. The timing of
corrective surgery can be critical and may occur during or after completion of growth. Orthodontic consultation and treatment
in conjunction with surgical correction are frequently necessary and highly favorable in most cases. Radiographic evaluation prior
to or following treatment is critical, but should be used as clinically indicated. Treatment planning can involve single or multiple
separate, staged surgical and nonsurgical treatments. Other nonsurgical specialties may also be helpful or necessary for completion
of treatment in more complicated cases. Therefore, treatment planning is very important in order to reach the optimum goals but in
some cases the surgeon may face challenges during the set up of the treatment plan. In this presentation, there will be guidance how
to manage complex cases with some learning points and tips for the operative and surgical techniques. Several difficult cases had
been selected such as ; Binder Syndrome , long face syndrome , bilateral cleft lip and palate with different treatment plan modalities
in a problem solving manner.