Unlike the midface hypoplasia associated with Crouzon syndrome, Apert facial dysmorphology has been described as an abnormal face in an abnormal position. The Apert midface deformity is characterized by a dual concavity, with more severe deficiency in both the sagittal and vertical dimensions of the central midface relative to the lateral face. En bloc Le Fort III subcranial advancement cannot correct this unique dysmorphology and moves an abnormal face into a more normal position. Segmental approaches such as Le Fort II distraction with zygomatic repositioning (LF2ZR) or bipartition frontofacial distraction are better suited to correct the Apert facial ratios. They combine the benefits of distraction osteogenesis with the directional control of traditional techniques to create differential movements. Both techniques have benefits and disadvantages, so each case of Apert syndrome should be analyzed before midface surgery to determine which approach would best treat the most dominant aspect of dysmorphology.