Aging changes to the anterior neck can produce skin laxity, accumulation of submental fat, platysmal banding, and ptosis of the underlying neck structures. To rejuvenate the cervicomental region, the surgeon must accurately diagnose the anatomic irregularities and make appropriate recommendations for surgical correction. Because there are wide variations of anterior neck anatomy among individuals, it is necessary to “customize” the surgery in this area for each patient by employing single isolated procedures or multiple techniques. A stepwise approach in the management of the submentum can facilitate this goal and guide the surgeon in selecting the appropriate procedures for each individual.