The authors present a thirty two years old women complaining of a temporomandibular joint ankylosis. History revealed a mandibular trauma sustained during the early infancy. The patient presented a typical bird face deformity with a maximal mouth opening of zero millimiter. Facing the squelettal deformation, the authors decide to combine a simultaneous costochondral graft with bilateral horizontal branch distraction. Good functional and aesthetic results allow the patient to return to a good social integration with no sign of recurrence at the medium term follow-up.