In recent years there has been a growing enthusiasm for minimally invasive surgery in the field of surgery. The words “percutaneous”, “small incision”, “minimally invasive” and “no fixation” are indeed very attractive. It is no wonder that patients are rushing to them. After having been exposed to a number of revision cases, I would like to give my opinion today in an objective manner. It is true that minimally invasive treatment with small incisions is one of the surgical options for bunions, but bunions are not a simple disease, they are not just cosmetic big feet, but a combination of imbalances in the soft tissues of the bunion and/or surrounding phalanges. Surgical considerations involve many factors such as metatarsal/toe deflection angle, joint surface angle, joint stability, seed bone dislocation and degree of lesion, soft tissue balance, etc. Moreover, in many cases the cause is not in the forefoot, for example, gastrocnemius contracture can cause bunion due to increased forefoot weight bearing, flatfoot syndrome can cause bunion due to increased forefoot stress, mid and hindfoot lesions can also cause forefoot involvement, etc. Therefore, there are many different procedures for bunions, sometimes dealing with the metatarsals, sometimes the phalanges, and sometimes the midfoot, so there is no one way to deal with them all. On the other hand, let’s look at the operation of the bunion incision. During the operation, the bunion has to be removed, the bone has to be osteotomized in different areas, and the underlying seed bone and the lateral soft tissue have to be dealt with. Therefore, except in cases of mild bunion with a good articular surface match itself, a simple small incision offers too little scope for manipulation. Imagine trying to do a very complex job and only being given a small space to operate, there are bound to be problems of inadequate exposure and poor visualization, with only two possible endings: either a simple operation or a much more traumatic blind internal operation despite the small surface incision in order to be able to achieve the goal. Thus, we prefer incisional surgery with full exposure and a clean and clear view. In addition, open surgery can be adjusted to the direction of the osteotomy depending on the specific condition. Sometimes a slight adjustment can make a big difference in the angle. Small incisions, however, generally use a grinding drill to break the metatarsal bone, which often results in more bone loss than open surgery and can easily cause the bunion to shorten too much, resulting in lateral metatarsalgia. Repositioning as well as strong fixation are the principles of orthopedic surgery. However, some surgeons do not use internal fixation and use bandages or dressings for the purpose of early postoperative walking and no need to remove the internal fixation, which is actually very dangerous and can easily result in unreliable fixation of the osteotomy for deformed healing. In addition, it should be recognized that it does not mean that the nail or plate can not be weight-bearing, even with internal fixation, most of the forefoot surgery can wear postoperative shoes as soon as possible after walking.