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This case report describes a surgical orthodontic case that used the recently introduced surgery-first approach to correct a severe skeletal Class III malocclusion. A 19-year-old woman presented with severe mandibular prognathism and facial asymmetry; she had been waiting for growth completion in order to pursue surgical correction. After prediction of the postsurgical tooth movement and surgical simulation, 2-jaw surgery that included maxillary advancement and differential mandibular setback was performed using a surgery-first approach. Immediate facial improvement was achieved and postsurgical orthodontic treatment was efficiently carried out. The total treatment time was 16 months. The patient’s facial appearance improved significantly and a stable surgical orthodontic outcome was obtained.We treated a surgical orthodontic patient with the recently introduced surgery-first approach.Postsurgical orthodontic treatment was efficiently carried out, and the total treatment time was reduced.A stable surgical orthodontic outcome was obtained.