Sorry for the late reply, but figure it may help others who stumble across these posts.

Braces are mandatory - interview a couple orthognathic surgeons and ask them though.

Risks - there are always risks with anything, like driving to work every day. If you find a good surgeon that does orthognathic procedures frequently (mine does one or two of them every week), the actual risks are minimal these days, and you will be very happy that you went through it if you need it.

Stephanie's post - I disagree. If most of the orthodontists said your brother should go through orthognathic, he probably should do it ... just because he found one orthodontist that will take his money and fix it as best he can does not mean this will be the best outcome and that your brother will be happy with the results. For everyone else, try to do what is the right treatment the first time - if the right treatment is just braces, that's great - I would think your could overcome up to a few millimeters offset with orthodontics alone. Most people inquiring about orthognathic surgery are in a different category though. If your brother is unhappy with semi-alright braces results, then to reverse everything they are doing now will take the same amount of time ... another 2 years of braces at a later age plus the surgery. Hopefully he does not need to go through that though.

ctoler1920 - How many millimeters is your overbite? If they can flare your bottom teeth forward slightly and be within a few millimeters of where your jaws should be, then I would probably go with that. If it is more distinct than that, I am guessing you will be happier with the results of orthognathic.

Good luck all!