The aim of this research was to determine the soft-to-hard tissue ratio using three-dimensional (3D) analysis in different types of orthognathic surgery and to update the most recent scientific evidence provided in 2017. A systematic search covering the period January 2017–December 2023 was performed in the MEDLINE, Embase, LILACS, Scopus, and Science Direct databases to identify relevant studies. The methodological quality of the included studies was assessed using the method proposed by the Effective Public Health Practice Project. Of 897 articles identified in the database search, 10 were included in this review. These articles included analyses of points or anatomical areas of the face, and all of them used image superimposition for the analysis. The clinical analyses of the perinasal region, upper lip, and chin region produced ambiguous results. The bias in methods and variables, such as the types of surgery, patient variables, and differences in diagnosis may limit the use of the information obtained. There are no data that can be applied to daily clinical practice; the limited evidence that was previously published in 2017 remains.