This study investigates the motivations and expectations of orthognathic surgery patients and their post-surgery satisfaction. The secondary objective was to explore the factors that affect expectations and satisfaction in patients undergoing single and double-jaw procedures. The retrospective single-center cohort study was conducted at Ondokuz Mayıs University. The study population consisted of patients who underwent orthognathic surgery by a single maxillofacial surgeon between 2016 and 2023. The study's inclusion criteria were as follows: no previous maxillofacial surgical operation, an indication for orthognathic surgery, being at least 15 years old, and no medical or mental problems that would contraindicate surgical operation. Individuals with congenital anomalies such as cleft lip and palate and those with dentofacial deformities resulting from trauma, surgical assist rapid maxillary expansion, genioplasty procedures, and posterior segmental osteotomies were excluded from the study. The study included 127 patients (79 females and 48 males) with a mean age of 22.3 ± 4.69 years (range 16-39 years) who underwent orthognathic surgery. Specifically, aesthetic expectation priority was statistically significantly higher in females (p <
0.001) and singles (p = 0.028). Intraoperative or postoperative complications statistically significantly affected satisfaction (p = 0.012). Class II patients were treated with statistically significant single jaw surgery (p = 0.003). These findings underscore the importance of personalized treatment planning, considering the surgical and anatomical requirements and the patient's demographic characteristics, expectations, and potential risk factors. Addressing patient priorities and minimizing complications is crucial for optimizing satisfaction and long-term outcomes in orthognathic surgery.