In this work, we present a generic approach for biomechanical simulation of two typical boundary value problems arising in cranio-maxillofacial surgery planning, i.e. the prediction of patient’s postoperative appearance for a given rearrangement of bones and the reverse optimization of individual facial implants for a desired correction of facial outline. The paper describes the basic methodology for the generation of individual geometrical models from tomographic data, incorporation of the boundary conditions, finite element modeling of tissue biomechanics and experimental results of applied clinical studies.