Objective To explore the indications and clinical effects of simultaneous mandibular angleplasty on the unaffected side, performed using preformed titanium mesh combined with mandibular angle bone graft, for the treatment of hemifacial microsomia (HFM). Methods The study group included 11 patients between 2013 and 2021 with HFM who underwent simultaneous mandibular angle reduction of the unaffected side and augmentation of the affected side using resected bone scaffolds within the titanium mesh. A series of mandibular linear measurements such as ramus height(RH)and mandibular body length(BL), angular measurements, and asymmetry index combined with clinical photographs and postoperative complications were used to assess the therapeutic effect. Results Postoperatively, all patients were satisfied. Significant improvement in mandibular contour was shown, with no obvious complications. Postoperative data, such as BL and angular measurements, showed no statistically significant differences(P>0.05) between the affected and unaffected sides with improvement in symmetry, except for RH(P<0.05). The preoperative and postoperative asymmetry index were (17.11±4.56)% and (4.81±1.73)%, respectively, with significant improvement(P=0.002). Conclusion This approach provides satisfactory results and significantly improves facial asymmetries for unilateral HFM with hypertrophy of the contralateral mandibular angle.