For all patients, the goal was to achieve significant improvement of function and asthetics via fibular "wrap-around" augmentation. Further advantage of this operation method is transoral positioning without profound submandibular incision lines. However, the method is very work-intensive regarding a non-compromised perfusion due to very narrow anatomical relationships. With limited cases - as a result of the rare occurence of the situation - transoral positioning is the therapy of choice (despite high work intensity). Sustainable augmentation is achieved. It may be suitable to combine the operation method with soft tissue augmentation - for example with fatty tissue aspiration or free SIEA micro-anastomotic tissue transplant. Keywords: augmentation, fibular transplantation, mandibular hypoplasia