The answer is a little bit complex; however, craniofacial surgeons are trained, generally speaking, in the United States as medical doctors who have completed a general surgery and plastic surgery residency and then have gone on to do craniofacial surgery training. These physicians generally are skilled in skull bone reshaping and in orbital surgery. They are also highly trained in cleft lip and cleft palate. Generally speaking, most craniofacial surgeons in the United States are not as well trained in orthognathic surgery, which tends to be the purview of maxillofacial surgeons in the United States. The European system is slightly different from us. Maxillofacial surgeons in the United States more often than not tend to be dentists. They have often gone on to do a residency in oral and maxillofacial surgery, often otherwise known as OMFS. The purview often includes as part of that orthognathic surgery, but more often than not, the vast majority of that field is doing bony tumors, dental implants, and complicated and/or impacted tooth extractions.