A combination of orthodontic and orthognatic surgery was planned for a 18-year-old male with class III malocclusion, mandibular asymmetry, unilateral crossbite and open bite. After 10 month of pre-surgery orthodontic treatment, mandibular setback was done. Unexpectedly, two weeks later the right fixation plate were exposed intra-orally and had to be removed. Eventually, the return of mandibular assymetry and midline shifting were inevitable. This required an extensive post-surgery orthodontic treatment to distalize the right lower segment using miniscrew.