Surgery is indicated only when a clear clinical indication exists, established following a specialist maxillofacial assessment. In general, surgical intervention is considered when the problem is structural or functional in nature and cannot be effectively managed through conservative means — for example, in cases of skeletal malocclusion with significant functional limitation, facial fractures or trauma, or specific TMJ conditions where surgical criteria are met. The decision is not based on a single symptom, but on diagnosis, severity, functional impact and treatment objectives. During the consultation, alternatives, expected outcomes and risks are clearly explained to support an informed decision.