Pelo S, et al. – This study's aims were to examine and assess the differences detected by the patients between the traditional orthognathic approach and the surgery–first one in terms of the level of satisfaction and quality of life. The results seemed to suggest that the worsening of the facial profile during the traditional orthognathic surgery approach decompensation phase has a negative effect on the perception of patients’ quality of life. Therefore, surgeons should consider the possibility of a surgery–first approach to prevent this occurrence.