Closed reduction is not sufficient for the zygomatic complex fracture and unstable zygomatic arch fracture because of a lack of stability. So open reduction must be considered, but the incision over the zygomatic arch and zygomaticofrontal area may injure the facial nerve and leave an undesirable scar. The use of the frontotemporal incision allows maximal exposure of the lateral and superior orbital rim and zygomatic arch while minimizing risk to the facial nerve branches, and also produces a cosmetically acceptable scar. No major complications occurred in 18 patients undergoing the frontotemporal incision procedure with good exposure for accurate surgery and acceptable cosmesis.