Background:  The aim of this study was to compare per cutaneous osteotomy technique with endonasal technique.

Materials and Methods:  Two groups of ten patients each were included in this study. One group underwent percutaneous osteotomy and other group underwent endonasal osteotomy technique for lateral osteotomies. Post operative edema and ecchymosis was evaluated in both groups using Kara and Gokalan scoring system.

Conclusion: Per cutaneous technique of osteotomy is a precise and easy approach to carry out fracture along a preset line. The fracture is greenstick type so the bone stump is stable. Dorsal irregularities if any can be rasped immediately after the osteotomy. Mucosal injury, bleeding, lacrimal sac injury, edema, ecchymosis are much less in this technique compared to endonasal technique. Cutaneous external scar at the site of osteotomy is invisible in all cases after few weeks of surgery.