Jong-Woo Choi - The Surgery-First Orthognathic Approach: With discussion of occlusal plane-altering orthognathic surgery

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The surgery-first approach (SFA) or the surgery-first orthognathic approach (SFOA) can be defined as an approach based on going directly to orthognathic surgery without presurgical orthodontic treatment, which used to be a pre-requisite for traditional orthognathic surgery. Therefore, SFA is a concept that is not only challenging the status quo but is also a new paradigm in craniomaxillofacial surgery.

In the early 2000s, some Korean orthodontists started the modern concept of surgery-first approach under the name of functional orthognathic surgery which means that postsurgical orthodontic treatment could be more effective and functional compared to presurgical orthodontic treatment. And they had already published the surgery-first concept in The Korean Journal of Clinical Orthodontics. This article clearly addressed and described the surgery-first orthognathic approach without presurgical orthodontic treatment, which is the fundamental basic concept underlying our current surgery-first approach.

I have cooperated with this orthodontic group since 2006 for the surgery-first approach and found out the surgery-first approach could work very well in many cases. Now that we could get the clinical results in our practice consistently for the last 15 years and have proved the efficacy and validity based on numerous SCI articles, I , JW Choi, and my partner orthodontist, JY Lee, thought that it is time for writing a book in order to share our clinical experiences and knowledge about our surgery-first approach. This book is the result of our hard work and essence of our collaboration for the last 2 years for completing this book.

Regardless of the specialty, we hope this book will help the surgeon and orthodontist understand the modern surgery-first approach and be able to apply this concept to their clinical practice, which would be not only a very effective tool but also a paradigm shift in orthognathic surgery.

Finally, as a surgeon, I am very grateful that my teachers, BY Park, DH Lew, and YO Kim, who guided me to the world of craniofacial surgery. In addition, I thank YR Chen, Philip Chen, LJ Lou, Sabine Girod, NC Gellrich, and Eduardo Rodriguez who helped me learn the updated techniques in craniofacial and orthognathic surgery. Lastly, I appreciate the consistent support of KS Koh and JP Hong as mentors in my life. Without all of them, I would not be what I am now.

As an orthodontist, I am extending my sincere appreciation in memory of Dr. William R. Proffits enthusiasm for making the cornerstone of surgical orthodontics. And I would like to express my deep gratitude to Dr. HS Baik, who has given me the philosophy of treating patients with surgery, and Dr. YC Park, who has played a pioneering role in TADs and taught me. Also, I am grateful to professors of the Department of Orthodontics at Yonsei University and Dr. KJ Kim and Dr. TK Kim.