Until recently, little has been written concerning the area of combined orthognathic and rhinoplastic surgery. This may be due to the paucity of surgeons trained in these disciplines and the technical difficulty of the simultaneous performance of surgical procedures. A general appraoch to combine orthognathic and rhinoplastic treatment planning is presented in this paper. The advantages and disadvantages of combined orthognathic and rhinoplastic surgery are discussed and guidelines for performing combined surgery are given.