Longstanding unilateral temporomandibular joint ankylosis, which starts during the active growth period in early childhood, results in facial asymmetry. Three problems are encountered: the ankylosed joint; the asymmetric face and, occasionally, upper airway obstruction. Simultaneous surgery was performed on 27 patients to release the joint ankylosis and to correct the facial deformity. Bimaxillary surgery was done for adult patients with occlusal canting, and mandibular surgery alone for adult patients without occlusal canting and for young children. Very satisfactory results were obtained during a follow-up period ranging from 2 to 6 years, regarding the restoration of joint function, improvement in aesthetic appearance and relief of respiratory obstruction.