Synkinesis is characterized by mimetic asymmetry during facial expression and during rest, resulting from a mixture of hypotonic and hypertonic muscles as well as involuntary facial movements while performing voluntary facial expressions. This chapter will detail the indications, surgical techniques, and complications of four integral surgical procedures for treating synkinesis: myectomy, neurectomy, local muscle transfer, and free functional muscle transfer. Though only an example addressing a specific muscle or nerve group is described per procedure (e.g., depressor anguli oris myectomy as an example of myectomy) in this chapter, the same operative principles can be applied for treating synkinesis of other facial muscles.