To optimize treatment of zygomatic bone fractures, patients' subjective evaluations of symptoms are necessary. The visual analog scale (VAS) was used for the quantitative assessment of subjective evaluation for symptoms and treatments in patients who underwent open reduction and rigid fixation. Degree of satisfaction and annoyances resulting from residual symptoms (deformity, pain, paresthesia, and trismus) and incisions used for exposure of the fracture site were investigated using an anonymous postal questionnaire. Forty-three patients provided responses. Total satisfaction was rated as 72.5% +/- 21.6%. Scores from the VAS for annoyance were significantly higher for paresthesia than for deformity, pain, or trismus. Residual deformity and pain significantly influenced total satisfaction. Upper vestibular, lower lid, and lateral brow incisions showed almost equivalent tendencies for annoyance. The VAS provided otherwise inaccessible information about patients' subjective evaluation. Treatment strategies should be optimized toward not only evaluation with objective measures but also patients' subjective evaluation.