The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient. Custom made three-dimensional (3D) printed implants have earlier been demonstrated to be an ideal solution in deformity surgery and in reconstruction of complex posttraumatic cases. In this study, we report the novel use of patient-specific saw and drill guides combined with patient-specific 3D titanium alloy implants as a fixation system in maxillary movement after Le Fort I and bimaxillary osteotomies (n = 32). The implants were individually designed for each patient to follow anatomical structures and to provide exact positioning and stability of the repositioned maxilla. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.