Self-perceptions of facial appearance are important in patients' willingness to seek treatment. Unfortunately, patients usually only perceive defects of the mandible, making counseling regarding other facial deformities difficult for the orthodontist and oral surgeon. Self-drawings of profile form may be used by orthodontists to determine patients' understanding of their facial defects and to help educate patients about their defects and the need for surgical or other correction. This study of 35 patients seeking orthognathic surgery revealed that pateints' self-ratings of their vertical, mandibular, maxillary, and dentoalveolar defects are correlated with some cephalometric measures, as are their self-drawings of the vertical and mandibular dimensions. Therefore, it appears that the two self-assessment techniques may be used simultaneously to illustrate defects on different dimensions. Overall body image and facial image were not associated with cephalometric measrues, suggesting that patients' general feelings about their facial appearance are unrelated to their descriptions of their features or to objectively determined defects. However, self-ratings on sp ecific features of the face were correlated with cephalo metric measures of nasal height, on both hard and soft tissue dimensions.