Sagittal mandibular ramus osteotomy (SSRO) has undergone some modifications in terms of the position of the osteotomy and its extension, and it continues to be a versatile and efficient procedure for the treatment of facial deformities. The usual tools to perform the osteotomy include the motor with rotary drills and the reciprocating saw, and recently tools like the laser or the piezoelectric system have been included. The piezoelectric system shows advantages for the safety in the osteotomy and has allowed the development of new techniques that improve the execution and the prognosis of the surgery; the present report shows the technique for SSRO using exclusively the piezoelectric system, without the support of a chisel or other tool during the osteotomy.