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Techniques in Cheekbone Reduction

 

cheekbone reduction osteotomies Dr Barry Eppley IndianapolisCheekbone reduction, also known as reductive malarplasty, is a common operation in Asian patients. (although it can and is performed in patients of all ethnicities) There have been numerous cheekbone reduction osteotomy techniques that have been proposed, each with their own merits and proponents. But it is an operation that is not complication free of which the most common problems are cheek soft tissue sagging and non-union of the osteotomy site.

In the June 2016 issue of the Journal of Plastic Reconstructive and Aesthetic Surgery an article on this subject was published entitled ‘Reduction Malarplasty using a Zygomatic Arch-Lifting Technique’. A total of 54 patients underwent this type of cheekbone reduction surgery over an 18 month period.The reduction technique creates an L-shaped osteotomy of the zygomaticomaxillary junction through an intraoral approach. A prefabricated U-shaped microplate and screws was used for arch fixation in the lifted position. The follow-up period ranged from 6 to 18 months and the results were assessed by postoperative CT scans.

The results of this zygomatic arch lifting technique was one of general satisfaction with the aesthetic outcomes. There were no major complications such as buccal branch facial nerve injury or protracted trismus. (difficult with opening) Inadequate bony contact occurred in two patients due to unanticipated trauma with immediate reduction and fixation thereafter. Minor wound infections developed in three patients which resolved with antibiotics.

masseter muscle attachment to zygomatic archRegardless of the osteotomy pattern, techniques in cheekbone reduction must factor in how to stabilize the new position and resist the pull down forces of gravity and the masseter muscle. This requires a stable form of  bone fixation which always consist of some form of plate and screws. The use of such rigid bone fixation overcomes the design of almost any form of osteotomy design. In this arch-lifting technique the zygomatic complex is elevated thus ensuring an adequate bone to bone contact allowing for predictable and accurate aesthetiuc outcomes.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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