Assessing patient outcomes guides our surgical practice. In order to determine our performance as an orthognathic service, our standardised survey was used to explore the patient’s motivations, expectations and experience of treatment. The survey was carried out on an annual basis, addressing 53 parameters of care in 7 subsections based on the patient journey. The response rate averaged 70% per year. 103 patients were surveyed in total, over 4 years. Reasons for seeking treatment (straighter teeth, better appearance) remained constant. The psychological implications are clear, however; nearly all report an improvement in facial appearance and confidence (95%). Improvements made have reduced length of stay to a median of 1 day. Significantly, based on previous results, post-op dietician support has increased (100% vs. 78%), as has pain management, and satisfaction with clinical staff. Post-operative complications and concerns (e.g. numbness) are also addressed. Overall, satisfaction is 96% with surgery and the same percentage would recommend the unit. The paper emphasises the need for on-going assessment of our outcomes of the entire patient journey. Improvements have been made: these are less to do with the surgery itself, and have more to do with the immediate post-op experience and understanding and managing patient expectations.