Orthognathic surgery became more popular because people are more interested in facial profile
changes and are more receptive to surgery. As people seek beauty as well as function in maxillofacial
surgery, patient’s aesthetic demand becomes higher. Considering these big changes, one of the
major reasons is surgery-first orthognathic approach (SFOA), which removes pre-surgical orthodontic
treatment. Pre-surgical orthodontic time has been a great barrier to patients in terms of time and
social rehabilitation. By SFOA, patients can get surgery as soon as they make up their mind; Patients
from abroad can get surgery and get back to their country; They can go back to their work more easily
because their occlusion is more acceptable. Surgery first orthognathic approach is still developing in
practice and principle. However, as it is based on patient’s need, it will play a greater part in the field
of orthognathic surgery. Surgery first orthognathic approach together with aesthetic two jaw surgery
are expected to change the paradigm in orthognathic surgery.