Objective To explore the surgical management of Treacher Collins syndrome（TCS） which is a congenital craniofacial malformations affecting the structures derived from the first and second brachial arches.Methods The surgical approach is staged reconstruction,including upper facial reconstruction with specially designed outer calvarial table,mandibular lengthening by distraction osteogenesis technique,orthognathic surgery to correct the birdlike facial appearance and anterior open bite,as well as lipo-filling for the correction of residual depressive deformities.Results Two adult patients have undergone this protocol and the results were satisfactory.Conclusion The staged reconstruction is a good way to correct the deformity of the adult patient with complete Treacher Collins syndrome.