In orthognathic surgery, particularly when performing osteotomies of the mandible, the significance of the inferior alveolar and marginal mandibular nerves cannot be overstated. Their susceptibility to damage, owing to their anatomical positioning, renders them particularly prone to stretch-induced trauma or even total severance amid procedures like genioplasty. This chapter discusses the most up-to-date methodologies for addressing and mitigating the sensory and motor nerve impairments that can arise from such surgical interventions.