BACKGROUND: Advances in three-dimensional technology have enabled applications for the clinical setting to be created and used in routine diagnosis, treatment planning, and patient education. The objectives of this prospective clinical trial were to determine the volume changes associated with facial swelling following orthognathic surgery. METHODS: Twelve subjects requiring orthognathic surgery were recruited for the study. Laser scanned images of the subjects were obtained under a reproducible, controlled environment with two laser-scanning devices assembled as a stereo pair. Three-dimensional laser scans were recorded over six time periods, as follows: T1, presurgical scan; T2, 1 day postoperatively; T3, 1 week postoperatively; T4, 1 month postoperatively; T5, 3 months postoperatively; and T6, 6 months postoperatively. RESULTS: The results showed a clinical difference in the mean shell deviations between bimaxillary and single-jaw orthognathic surgery. Furthermore, the results suggest that the mean volume of swelling was reduced by approximately 60 percent within the first month after surgery. Finally, the amounts of swelling following surgery were greater in bimaxillary cases. The recovery in the swelling was also faster in this group of patients. CONCLUSIONS: Three-dimensional imaging has opened up new avenues of patient care and treatment evaluation. The results have shown that the laser scanning device and the method described are a reliable and accurate measure of facial swelling following surgery. ©2007American Society of Plastic Surgeons.