The objectives of this study were to analyze outcomes with miniplates in orthognathic surgery and define risk factors resulting in plate removal. Clinical files of 570 orthognathic surgery patients operated between 2004 and 2009 were reviewed: 203 had a bimaxillary operation, 310 a lower jaw osteotomy, and 57 an upper jaw osteotomy. Age, sex, and jaw movement were analyzed. Reasons for hardware removal were recorded. Hardware was removed in 157 patients (27.5%). Seventy-eight patients (13.7%) needed removal because of plate-related infection; 66 (11.6%) because of clinical irritation; 5 (0.9%) for dental implant placement; and 8 (1.4%) for other reasons. Average time between operation and removal was 9.9 months. More women (31.7%) than men (20.3%) had plates removed, but age was not a factor except with infection. More than a quarter of patients developed complications from plates and screws, necessitating their removal, and infection occurred in 13.7%. Prompt removal constituted adequate management. Copyright © 2011 Mosby, Inc. All rights reserved.