Dear Graham, Please see my message posted July 17 about jaw distraction. I am concerned that any doctor would want to do distraction on a child younger than 4 or 5. I do have a friend whose daughter had the external device on her daughter this year and her daughter is 2. That surprised me a lot. She did have complications with the device and it had to be removed and the jaw repositioned and wired shut. Kind of like having two operations. She is pleased with the outcome, but she will tell you that is was very difficult. Please respond if you want about my experience with the internal and/or I can put you in touch with her if you wish. Thanks, Japetha