There are a number of different surgical options for floating bunions, the more traditional way being bunionization. If bunionization is done, there is no need for a skin graft because there is already more skin in this way, so there is no need to remove skin for a skin graft. If a metatarsal graft is performed, a skin graft may be needed because there is relatively little skin to remove from the foot. With changes in surgical approach and technique, we are now able to reconstruct the metatarsal with a hemimetacarpal graft without the need for a skin graft. Whether or not a skin graft is needed depends on the postoperative trauma. If the trauma is small enough to be sewn up, a skin graft is not needed. Although the scar is bigger after sewing up, the overall healing time is shortened and it will be easier for parents to take care of it. However, if the scar is too obvious, or the tension is too high, then a small skin graft is needed. Skin grafting involves problems of survival, pigmentation and scarring in the donor area, so we will try to avoid skin grafting, and only choose skin grafting when there is no other way.