The surgery first approach offers an alternative to the orthodontics-first approach for correction of maxillofacial deformity. The final outcomes, in the way of facial esthetics, dental occlusion, and stability, are similar when using orthodontics first and surgery first approaches. Dental occlusion and facial esthetics can show immediate improvement after surgery when using a surgery-first approach; this almost eliminates the time spent on preoperative orthodontics. The phenomenon of postoperatively accelerated orthodontic tooth movement also reduces the difficulties associated with and the time spent on postoperative orthodontics. Both the surgeon and orthodontist using a surgery-first approach should be experienced and should cooperate closely to achieve predictable and satisfactory outcomes. Further studies, especially prospective cohort studies or randomized controlled trials, are needed to provide additional clinical evidence to support the surgery first approach.