Aesthetic refinements in patients with Apert syndrome are vital in enhancing psychosocial outcomes, particularly during adolescence and adulthood. This chapter outlines the ancillary surgical procedures that may follow primary craniofacial reconstructions, emphasizing the importance of individualized treatment plans tailored to each patient's needs and expectations. While no standard protocol exists, orthognathic surgery—preferably before rhinoseptoplasty—is often a key step. Procedures described include bicoronal scar revision, correction of frontal/calvarial irregularities, frontal sinus reduction, lateral and medial canthopexies, genioplasty, rhinoseptoplasty, and fat grafting in the temporal and zygomatic regions. Each technique is discussed in detail, with a focus on anatomical considerations, technical steps, potential complications, and optimal timing. Frontal sinus reduction, for example, addresses hypertrophy and over-pneumatization frequently seen in Apert syndrome, while fat grafting improves soft tissue contours and facial harmony. These secondary interventions are crucial for achieving optimal facial aesthetics and should be timed appropriately, following skeletal maturity or significant facial growth. Patient counseling and expectation management are crucial, particularly when tissue characteristics or growth-related factors may limit the results. This comprehensive approach underscores the multidisciplinary nature of Apert care and the importance of long-term follow-up into adulthood.