Expedited correction of significant dentofacial asymmetry using a "surgery first" approach.

mark of facial attractiveness.1,2 Skeletal asymmetries generally require surgical intervention to improve facial esthetics and correct any associated malocclusions. The classic approach in volves a presurgical phase of orthodontics, during which dental compensations are eliminated, and a postsurgical phase to refine the occlusion. The presurgical phase can be lengthy, involving tooth decompensations that often exaggerate the existing dentofacial deformities.3 Skeletal anchorage now makes it possible to eliminate the presurgical orthodontic phase and to correct minor surgical inaccuracies and relapse tendencies after surgery. In addition to a significant reduction in treatment time, this approach offers immediate gratification in the correction of facial deformities,2 which can translate into better patient compliance with elastic wear and appointments. Another reported advantage is the elimination of soft-tissue imbalances that might interfere with ortho dontic tooth movements. This article describes a “surgery first” approach in a patient with complex dentofacial asymmetry and Class III malocclusion.