The purpose of this study was to use a 3-dimensional (3D) computer-aided design (CAD) simulation system to plan surgical procedures and predict postoperative changes in orthognathic surgery patients. A computer-generated imaging model was developed by combining a 3D reconstructed cephalometric skeletal image and a laser-scanned facial surface image. Moreover, postoperative data were studied and linked to the simulator model for programming and executing simulated surgical procedures. Interactive editing capabilities allow surgeons to operate CAD surgical simulation, and predicted results can be presented graphically and numerically. The results indicate that the integration of 3D images and CAD techniques have a potential for simulating surgery and providing graphic information to patients in obtaining an informed consent.