Patient presented with set-back upper and lower jaws and retrusive smile (bi-maxillary retrognathia and retrusion). Patient underwent orthodontic treatment with ceramic appliances and subsequently she had bi-maxillary advancement surgery (advancement Le Fort 1 maxillary osteotomy and downslide and bilateral sagittal split mandible osteotomy advancement) together with advancement genioplasty. This provided much more fullness to her smile and jaw structure. Patient also had wear on her upper front teeth and  white enamel spots – demineralisation – from a previous course of orthodontic treatment. With this in mind, we aligned and levelled the upper front teeth with reference to the upper gum margins. Patient will undergo treatment with her dentist to lengthen the upper front teeth with minimal composite bonding and have cosmetic dental treatment to reduce the white spots on the teeth. The orthognathic surgery was expertly done by Mr Manolis Heliotis, Consultant Oral and Maxillofacial Surgeon, 152 Harley street, London, W1G 7LH. https://www.manolisheliotis.co.uk