In the past, surgeons attempting to differentiate craniofacial and maxillofacial surgical procedures would use arbitrary anatomic boundaries. For example, surgical procedures involving anatomy above the inferior orbital rim would be considered by some to be craniofacial, while those below would be classified as maxillofacial. These comparisons often created confusion and did nothing to adequately describe the subspecialty of craniofacial surgery. Later, a more appropriate definition evolved, describing craniofacial operations as those procedures requiring a transcranial approach for access to the upper facial skeleton. Despite this distinction, however, craniofacial surgery represents an extension of the original scientific principles and traditional techniques of maxillofacial surgery. Maneuvers such as the creation of osteotomies, repositioning of skeletal components, and application of rigid fixation were initially developed for the correction of maxillofacial problems and later applied to the upper facial skeleton as part of craniofacial procedures. My first exposure to craniofacial surgery was during a lecture given by the late Dr. Victor J. Matukas, then Professor of Oral and Maxillofacial Surgery and Dean of the University of Alabama School of Dentistry. He described the original work of Tessier that resulted in the creation of the subspecialty of craniofacial surgery and shared his own experiences treating children with craniosynostosis and craniofacial dysostosis syndromes. Dr. Matukas