Kamel et al 8 reported the use of a posterior rotation flap technique during the distraction osteogenesis of ULS. The increase in intracranial volume was considered sufficient in this report. In addition, they showed that the posterior ration flap technique provides a sufficient increase in intracranial volume, and our method is comparable with their study. The bone flap in our method was slightly smaller than that in their study, and the location of the valve was localized near the occipital region. 8 Barrel stave osteotomy (case 2 only) and back cutting were added to increase intracranial volume, and an absorbable plate was used to reinforce the hinge area.In case 1, because the device was buried in the skin, the distraction was slightly inadequate. However, if the length of the device was made too long, it would become inconvenient for daily life. Consequently, it was determined that the length of the device should only be selected after the amount of distraction has been fully considered.The rotation advancement distraction osteogenesis technique is a simple method of treatment for posterior plagiocephaly, which is caused by unilambdoid craniosynostosis. However, this technique has limitations since we only tested it in 2 cases. Subsequently, a larger sample size and a longer follow-up are required to compare with other techniques.Furthermore, this technique did not provide any solution for the displacement of ears, or cranial base and facial deformity, and would require surgery to remove the device.