Objective: This study aimed to quantitatively evaluate the restoration of facial harmony in patients with severe skeletal deformities (Class II and Class III) following orthognathic surgery, using comparative photometric and cephalometric analyses. Methods: A retrospective cohort study was conducted on 60 patients (30 Skeletal Class II, 30 Skeletal Class III) who underwent bimaxillary orthognathic surgery (Le Fort I osteotomy and Bilateral Sagittal Split Osteotomy, BSSO). Standardized lateral photographs and cephalograms were taken before surgery (T1) and at a minimum of 6 months post-surgery (T2). Photometric analysis measured soft tissue angles (NLA, MLA), E-Line distances, and facial convexity (G-Sn-Pog'). Cephalometric analysis measured skeletal changes (SNA, SNB, ANB). Changes were analyzed using paired and independent t-tests (p < 0.05). Results: Both surgical groups demonstrated statistically significant (p < 0.001) improvements in all measured skeletal and soft-tissue parameters, leading to enhanced facial harmony. The Class II group showed significant mandibular advancement, with a mean increase in soft-tissue pogonion projection of +5.8 mm. The Class III group showed normalization of the midface and a mean reduction in facial concavity (G-Sn-Pog') of 7.1°. Photometric changes showed a strong and predictable correlation with the underlying skeletal movements. Conclusion: Orthognathic surgery provides profound and transformative corrections to the facial profile, successfully restoring facial harmony. Photometric analysis is an essential, non-invasive tool for quantifying the aesthetic outcomes of surgical correction. It complements cephalometric planning by providing a direct measure of the patient's perceived aesthetic result, which is the ultimate goal of treatment.

Orthognathic surgery, photometric analysis, facial harmony, skeletal deformity, cephalometrics, bimaxillary osteotomy, Le Fort I, BSSO

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