1 © Springer Nature Switzerland AG 2019 C. K. Chng et al., Surgery-First Orthodontic Management, https://doi.org/10.1007/978-3-030-18696-8_1 1 We are not makers of history. We are made by history. —Martin Luther King, Jr. Introduction to Surgery-First Orthognathic Approach (SFOA) 1.1 Introduction Surgery-first orthognathic approach is an emerging science whose roots can be traced back to the 1960s. An overview of surgery-first orthognathic approach shows the evolution of SFOA. ‘Jaw surgery’ pioneers and predecessors thought process and ideas are what shaped surgery-first orthognathic approach (SFOA). What was their approach, and what made the technique catch the attention of the ‘practitioners of the day’ and subsequently descended into oblivion for a considerable period of time? SFOA found a revival itself from a profound relying on ‘heuristic judgement’ of the early resurrection days to a more concrete epistemological method in the light of modern time’s evolved armamentarium and evidence. 1.2 Overview of Surgery-First Orthognathic Approach (SFOA) Conventional jaw surgery did originate sometime in the eighteenth century (1849) [13] when an American oral surgeon, Simon Hullihen (considered as the father of oral surgery), first performed jaw surgery to correct a prognathic mandible. It took another century (1957) for conventional jaw surgery to become a mainstay treat- ment for the correction of dentofacial deformity when two Austrian oral surgeons, Richard Trauner and Hugo Obwegeser, introduced sagittal split osteotomy, which then marked the foundation of the modern era of jaw surgery [4].