Adult patients who consult an orthodontist are looking for dental rehabilitation underpinned by an implicit esthetic demand, which needs to be analyzed. When the discrepancy involves more than the teeth and cannot be corrected by dentoalveolar compensation alone, there is a need, on account of the lack of growth, the periodontal setting and underlying dysfunctions, for an orthodontic-surgical solution. A clear understanding of the required future functional balance will help achieve a satisfactory esthetic target and give stable, lasting results.