Introduction: Planning for orthognathic surgery was enhanced through the past years and is performed nowadays using two-dimensional (2D) and three-dimensional (3D) planning methods. Aim: This project aimed to compare outcome of these two treatment planning methods according to improvements in clinical photographs of the subjects. Also, to compare the results from photographic evaluation with results on cephalometric accuracy measurements and Health Related Quality of Life (HRQoL) measurements in the same study cohort. Material & Methods: In a randomized controlled trial (RCT) design, a professional evaluation panel judged pre and post-operative photographs of 57 patients underwent orthognathic surgery in either 2D or 3D planning. Results were correlated to findings of cephalometric accuracy and HRQoL for the same cohort. Results: No significant difference between subjects underwent Orthognathic surgery in 2D or 3D planning (p>0.30). No significant correlation with HRQoL was found (p>0.30). A significant correlation between A point and overall facial esthetic was found (p=0.024). Conclusion : There is no esthetical advantage of using 3D planing over 2D planing for orthognathic surgery as judged by a professional evaluation panel.