The embryologic and postnatal development of the craniofacial region is an extremely complex process. Historically, patients who presented with complex craniomaxillofacial deformities were managed by focusing solely on the mandible with correction of the occlusion, without regard for the midface. Mandibular procedures long preceded the surgeon’s ability to address the midface and cranio-orbital regions adequately. H. Obwegeser’s LeFort I technique, followed by the transcranial approaches of P. Tessier, now allow the surgeon to address fully a complex range of craniomaxillofacial deformities. The surgeon today has the ability to disassemble the midface, either as a single unit or multiple units, in various planes, to address each patient’s unique deformity specifically.