A 26-year, 9-month-old woman had chief complaints of mandibular protrusion and facial asymmetry. Extraoral examination indicated mandibular deviation to the left side, severe facial asymmetry, and a concave profile. Because the patient had a vertical maxillary height difference and an occlusal plane cant together with maxillary retrusion, a differential downgraft and advancement surgery with Lefort I osteotomy was planned. To correct the facial asymmetry and mandibular protrusion, concurrent bilateral sagittal split osteotomy was performed. Double-jaw surgical procedures, including maxillary and mandibular movements, are effective in correcting severe facial asymmetry and skeletal Class III malocclusion.

Keywords: Facial asymmetry, orthognathic surgery, class III malocclusion