Purpose: This study aimed to assess soft tissue response following mandibular advancement surgery in class II malocclusion patients and to evaluate the correlation between soft and hard tissue changes. Patients &Methods: This study was conducted on 6 patients presented with skeletal class II malocclusion, indicated for bilateral sagittal split osteotomy (BSSO) for correction of mandibular retrognathism. Two patients out of them underwent bimaxillary surgical correction. Lateral cephalometric radiography was performed preoperatively, 1, 3 and 6 months postoperatively to assess soft tissue response following mandibular advancement surgery, correlations between hard and soft tissue changes, and the effect of short term skeletal relapse on soft tissue variables. Also a comparison between manual and digital lateral cephalometric tracing was carried out. Results: 1) The soft tissue changes in the chin area follow the horizontal and vertical dimensional changes of the bony chin in an almost 1:1ratio. The lower lip followed the lower central incisor tip in a ratio of 0.8:1 in the horizontal plane, and 0.9:1 in the vertical plane. 2) There was no statistical difference in the identification of lateral cephalometric landmarks manually or digitally using V-ceph software, and the intra-examiner errors were comparable between the two methods. Conclusions: 1) If skeletal relapse occurs, the soft tissue areas maintain their relationship with their skeletal counterparts. 2) Changes in facial esthetics after orthognathic surgery are highly dependent on the stability of the surgical procedure. If a more realistic long-term estimate of the resulting profile is desired, it is proposed that the mean relapse should be accounted when generating prediction tracings or images to demonstrate to the patient. 3) The results of our study substantiated the benefits of digital lateral cephalometric tracing in terms of reliability and time saving.