Surgery first: when surgery comes first
In some cases, surgery can come first.
In some cases, it's possible
A conventional treatment sequence has orthodontics at the beginning and surgery afterwards. In some cases, it's possible to do the surgery at the start and orthodontics afterwards, always with precise coordination between surgeon and orthodontist. That is surgery first. It isn't a shortcut or a simplified version of treatment: it's another way of ordering the path, evaluated case by case, and worth knowing about.
What changes
The order of the path changes, not the care that goes into it. Virtual planning anticipates how your bite will end up, and surgery brings the structure into that position from the start. Afterwards, orthodontics finishes placing the teeth where they belong, and in these cases it can move faster: after surgery, the bone has a more active metabolism for a while, something known as the regional acceleratory phenomenon, and that helps the teeth move. For you, the change in how you bite, how you breathe and how you look comes at the beginning of the process, and orthodontics is still an essential part of treatment.
When it's considered
It's evaluated by looking at the whole case: the condition of your teeth and gums, how much your bite needs to move after surgery, the state of your jaw joint, and whether the orthodontic and surgical plans can be precisely coordinated from day one. Often, people who have already had orthodontic treatment can choose this path, though not always. Your commitment to the follow-up visits that come afterwards also matters. Whether your case qualifies is decided at your evaluation, with your test results in hand.
The conventional path is still there
For many people, the conventional path—orthodontics first, surgery afterwards—is the most suitable, and it has its own advantages: the bite arrives prepared for surgery and the surgical plan builds on that foundation. Surgery first doesn't replace that path; it complements it. Both aim for the same thing: a face in harmony and a bite that works in balance. Which one suits your case, we decide together, with clear information.
Would you like to know whether your case could be surgery first? We find out at an evaluation, with your tests.
Frequently asked questions
What is surgery first?
It's a treatment sequence in which orthognathic surgery comes at the start and orthodontics afterwards, instead of the conventional order. It's a possibility in some cases, evaluated one by one, and it requires precise coordination between surgeon and orthodontist from the planning stage.
How do I know if I'm a candidate for surgery first?
It's decided at an evaluation, with 3D scans. We consider the condition of your teeth, gums and jaw joint, how much your bite needs to move afterwards, and how the orthodontic and surgical plans are coordinated. It's worth asking: knowing your options always helps you decide.
Can I choose surgery first if I've already had orthodontics?
Often, yes: people who have already been treated with orthodontics can qualify for this path, though not always. It depends on the current state of your teeth, your bite and your jaw joint, and on what your plan needs. We look at it at your evaluation, with your tests.
Does surgery first shorten treatment?
It changes the order, not how demanding the treatment is. Orthodontics is still needed afterwards, but in these cases it can move faster: after surgery, the bone has a more active metabolism for a while, and that helps the teeth move. How long it takes overall depends on each case.
Do I still need orthodontics?
Yes. In surgery first, orthodontics is done after surgery, to place the teeth in their final position on the new foundation. That's why it's key for your orthodontist and the surgical team to work in coordination from day one.
Can I have surgery this summer?
It depends on your case. If you're already in orthodontic treatment, or if your case qualifies for surgery first, the timing may be different from a treatment that's just starting. We find out at an evaluation, with your tests; operating room time is booked in advance.
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