Objective: To describe a new method for measuring facial swelling following orthognathic surgery using a 3D laserscanning device. Design: Prospective clinical trial. Setting and Sample Population: University Dental Hospital, Wales College of Medicine, Biology Life and Health Sciences. Three subjects requiring bi-maxillary orthognathic surgery were recruited for the study. Experimental Variables: Laser-scanned images of the subjects were obtained under a reproducible and controlled environment with two Minolta Vivid 900 (Osaka, Japan) optical laser-scanning devices assembled as a stereo-pair. A set of left and right scanned images was taken for each subject and each scan took an average of 2.5 s. 3D laser scans were recorded over six time periods (T1-pre-surgical scan, postoperatively: T2-1 day, T3-1 week, T4-1 month, T5-3 months and T6-6 months). Outcome Measure: Facial scans from different time periods were overlaid onto the baseline (T6) facial scan to determine the reduction and changes in swelling following orthognathic surgery. Results: The results showed that swelling could be accurately quantified following surgery. Furthermore, there was a significant reduction in the amount of swelling 1 month postoperatively. Furthermore, the facial morphology returned to approximately 90% of the baseline facial scan at 3 months. Conclusion: The 3D laser-scanning device and the method described was a reliable and accurate measure of facial swelling following surgery. © Blackwell Munksgaard 2006.