Facial plastic surgeons commonly see patients with submental laxity and an excess of skin and fat in the upper neck. This has colloquially been called the "turkey gobbler" deformity. In some cases, this deformity is the patient's only aesthetic concern, and full face-lift surgery is not desired. In this study, we reviewed the English-language peer-reviewed literature for descriptions of direct excisional submentoplasty techniques. Various designs for skin excision and wound closure have been used by surgeons over the past several decades. This article summarizes the surgical technique as well as the advantages and disadvantages of each method. Furthermore, we propose an approach that incorporates many of the other designs but to our knowledge has not been described previously in the peer-reviewed literature. An understanding of these numerous approaches will better enable facial plastic surgeons to appropriately address and correct patient aesthetic concerns.

The purpose is to assist the surgeon in the selection of modifications for nasal osteotomies. Details of the technique include: 1. Incision for osteotomy made perpendicular to the pyriform rim and modified incisions, intraoral or through the Weir incision. 2. Rasping of the lateral nasal vault prior to any osteotomies. 3. Removal of a modified beveled wedge of bone prior to the medial osteotomy, unroofing the bony dorsum to a higher level. 4. The medial osteotomy done prior to either the lateral or the intermediate osteotomy. The intermediate osteotomy is performed prior to the lateral. 5. “Complete” and “fading” medial osteotomies are utilized as indicated. 6. The lateral osteotomy may be relatively straight and low depending then on a transverse fracture or may be high and curved meeting the fading medial osteotomy. 7. A sub‐periosteal tunnel with the osteotome guard external to the bone is preferred to a submucosal tunnel.

The Farrior otoplasty is a graduated technique that has met with clinical success over the years. It combines elements of cartilage shaping and suturing procedures and as such is susceptible to complications such as suture extrusion and auricular protrusion that are ascribed to similar otoplasty methods described in the literature. It allows for a directed approach to correct the causative anatomic defects, while maintaining a natural appearance. While further research and long-term analyses are encouraged, this technique remains a valuable component of a facial plastic surgeon's armamentarium.