The concept of “surgery-first and orthodontics second” is called “SFOA” (Surgery-First Orthognathic-Approach) or “SFA” (Surgery-First approach). Surgery first approach is an alternative methodology to conventional orthognathic surgery (“Orthodontics– Orthognathic surgery– Orthodontics”) which performs directly an orthognathic surgery, without the previous orthodontic preparation, followed by a post-surgical orthodontic treatment. Surgery-first approach treats facial esthetics first and then occlusion, whereas the conventional approach treats occlusion first and then facial esthetics. The surgery-first approach uses osteotomy to solve both skeletal problems and dental compensation, and a "transitional" occlusion is set up postoperatively
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