More adolescents and young adults are requiring facial skeletal surgical procedures. They are vulnerable in emotional development, and the stress of surgery adds to this. Interaction between adolescent patients and caregivers must be assessed in treatment planning for a successful outcome. Focus is on correcting the morphologic deformity, but assessment and planning should also include psychosocial aspects of the patient. Adolescents and young adults who need psychological support should be followed closely from the beginning, until at least 1 year postsurgery. Success of surgical intervention should be measured both in terms of the occlusal function and morphological improvement, and changes in psychosocial interaction and an improved quality of life for the patient.