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The primary aim of this study was to explore patients' perceptions regarding the impact of 3D prediction planning (3D PP) of facial soft tissue changes following orthognathic surgery. The study was carried out on 30 patients who were shown photorealistic 3D soft tissue prediction planning before undergoing orthognathic surgery to demonstrate the expected facial changes. Distraction osteogenesis and cleft deformities were excluded from the study before consenting to surgery. Following surgery, the included patients were asked to complete a standard questionnaire to explore their perceptions regarding the impact, accuracy, and value of 3D prediction planning. The majority of the 30 participants perceived 3D PP to be beneficial in reducing their presurgical anxiety, increasing their motivation to undergo surgery, improving the accuracy of their surgical expectations, and enhancing doctor-patient communication. Most of the patients perceived their surgical soft tissue changes to be better than the predictions. Significant positive correlations were detected between satisfaction with the delivered service and the facility of seeing 3D PP (r s  = 0.4; p = 0.034). Similarly, 3D PP improved patients' confidence in the surgical decision (r s  = 0.4; p = 0.031), as well as increasing their motivation to undergo surgery (r s  = 0.5; p = 0.010). 3D PP was found to be effective in improving the quality of orthognathic surgical care., Competing Interests: Declarations of competing interest None., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)