The major needs for cosmetic facial bone surgery come from anatomic differences in facial shape and in personal preference. Especially when consulting patients with different national or ethnic backgrounds, careful attention should be paid during consultation for the ideal or desirable facial shape that they have in mind. Patients generally seek a slim and smooth-contoured face. Surgery of the cosmetic facial bone has developed from surgical experiences in facial bone trauma and congenital anomalies. A limited approach is recommended for satisfactory aesthetic outcome. Surgeons should understand the basic procedures of L-shaped osteotomy of the zygoma and intraoral mandible reduction.