Background: Mentoplasty plays a central role in facial harmony, particularly in the correction of chin asymmetries. Advances in digital planning and three-dimensional (3D) printing have enabled the development of patient-specific surgical guides; however, their clinical implementation in public healthcare settings remains limited by workflow complexity and accessibility. Methods: This case series describes three patients who underwent asymmetric mentoplasty using customized, in-house-manufactured 3D-printed cutting and positioning guides. Virtual surgical planning was performed using cone-beam computed tomography (CBCT) data, followed by guide design and fabrication through an in-house digital workflow. Postoperative CBCT was used for descriptive assessment of the correspondence between planned and achieved chin positions using predefined linear reference points. Results: Across the three cases, postoperative CBCT analysis demonstrated encouraging agreement between virtual planning and achieved surgical outcomes. The customized guides facilitated accurate transfer of the planned osteotomy and chin positioning in both symmetric and asymmetric movements. No major intraoperative or postoperative complications were observed. Guide fabrication required low material consumption, enabling rapid in-house production with minimal direct material cost. Conclusions: Within the limitations of a small case series, the proposed in-house digital workflow demonstrated technical feasibility and encouraging agreement between planned and achieved chin positioning in selected asymmetric mentoplasty cases. Further studies with larger samples and standardized accuracy assessment methods are required to confirm these preliminary observations.

Background: Facial asymmetry affecting the mandibular contour may significantly impact facial harmony even in patients with stable occlusion. Although orthognathic surgery remains the standard for skeletal correction, it carries substantial morbidity. In selected cases, contour-focused approaches can achieve meaningful esthetic improvement with reduced surgical burden. Objective: To describe the virtual surgical planning (VSP) workflow and clinical outcome of a unilateral Wing osteotomy for mandibular contour asymmetry. Case presentation: A 24-year-old woman presented with left-sided mandibular contour deficiency and facial asymmetry, despite stable Class I occlusion and preserved function. VSP with contralateral mirroring guided the design of the osteotomy and fabrication of a stereolithographic model and patient-specific cutting guide. Surgery was performed through a tunnelized mandibular approach using a 702 bur and reciprocating saw. Fixation was achieved with pre-bent 2.0 plates adapted to the 3D model, and Bio-Oss Collagen was interposed within the osteotomy gap. Occlusion and mental nerve function were preserved. Results: Postoperatively, the patient demonstrated improved facial symmetry, uneventful healing, preserved long-term neurosensory function, and high esthetic satisfaction. Conclusions: Unilateral Wing osteotomy guided by VSP and patient-specific instrumentation is a predictable, minimally invasive alternative to bimaxillary orthognathic surgery with genioplasty in selected patients presenting contour-focused asymmetry and stable occlusion. This case highlights a rare, underreported application of the technique.