The young adult with Apert syndrome is characterized by midface hypoplasia, exorbitism, and class III maocclusion of varying degrees. Bone facial structure is distinguished because midface hypoplasia is more pronounced in the central face and occurs along the sagittal, transverse, and vertical planes. The sagittal disharmony between maxillary and mandibular growth may lead to an anterior open bite and severe short face. Lately, techniques that utilize segmental osteotomies may produce additional benefits to the Apert midface treatment. Together with multi-piece osteotomies, today exist the possibility of combining osteotomies and bone distraction, which adds simultaneous soft tissues expansion, fact that increases the results quality and avoids complications. The use of osteotomies and distraction provide osteotomies stability, increase functional results quality, the occlusal relationship and the face aesthetics, carryng out simpler and more logical surgical procedures.