Two cases of severe facial asymmetry resulting from progressive facial hemiatrophy and hemifacial microsomia treated by two jaw surgery and hydroxylapatite (HA) block graft are reported. Both cases had a similar three-dimensional jaw deformity. Two jaw surgeries were performed to improve the occlusal plane inclination and the asymmetric contour of the mandible. HA blocks which were made from wax models on the mandible models reconstructed from CT, were grafted to improve the remaining deformity. Various problems associated with the procedures are discussed.