The lamellar split osteotomy is a new surgical technique which has application in craniofacial and aesthetic surgery of the facial skeleton. This method involves in situ splitting of the outer table of bone which is then changed in shape and contour allowing for referenced changes of facial and cranial vault contour form. This allows accurate means of enhancing facial balance and harmony. This video highlights live views of surgery showing this method as used in various anatomic sites; forehead, orbits, malar, and other combined augmentations. This method is stable and allows for accurate shaping and fixation using interpositional bone grafts for internal rigid fixation. The indications, including advantages and disadvantages of this technique, are presented.