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Dr. Barry Eppley

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Zygomatic Arch Osteotomy in Cheekbone Reduction


Narrowing the wide midface can be done only by bringing in the width of the zygomatic arches. The shape and convexity of the zygomatic arch, like a spanning bridge, is what creates the width of the face between the temporal regions of the head and the lower jawline. Moving this portion of the cheek in is done by a dual approach using an anterior intraoral and a posterior preauricular incisions. Once access is obtained the bone cuts can be done by numerous described osteotomy cuts to reduce both the cheek bone and the thinner arch connection to the temporal bone.

In the October 2017 issue of the Journal of Craniofacial Surgery an article entitled ‘Advantages of a Beveled Osteotomy on the Zygomatic Arch During Reduction Malarplasty’ was published. In this paper the authors describe beveling the osteotomy cut on the posterior zygomatic arch. This has numerous purported advantages including

enhancing bony healing by increasing the cross-sectional area for bone contact between the cut edges, decreasing palpability on the osteotomy site, placing the osteotomy more posteriorly, preventing depression in the anterior cheek region, and reducing the need for metal hardware.

Beveling of posterior zygomatic arch osteotomy in cheekbone reduction is a technique that I have always done. It allows the cut end to be pushed inward like a sliding wedge and does avoid the use of metal hardware in an area where it can be more difficult to apply. A straight cut may allow the end of the arch to be pushed in a bit further but not appreciably more than a beveled osteotomy cut.

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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