Cheek augmentation is most commonly done by onlay augmentation. A wide variety of cheek implants exist to achieve almost every type of cheek dimensional in increase. And if a standard cheek implant cam meet the patient’s aesthetic midface needs, custom cheek implants can be designed for even the most exotic cheek augmentation change.
But some patients do not prefer the use of implants in the face and seek a more natural or autologous cheek augmentation method. Cutting and repositioning portions or all of the cheek bone can be done but its effects are more dimensionally limited. Just like the cheek bone osteotomy used to narrow the cheeks, it can be similarly done to done to widen.
A sagittal cut through the main body of the zygoma can be done from an intraoral approach. This maintains the anterior attachment of the zygomatic arch to the outer cortex of the zygomatic body. This cantilevered cheekbone segment can then be pushed out to increase zygomatic width and help there with a plate and screws. An interpositional autologous or cadaveric bone graft can be used between the segments if desired.
This cheekbone osteotomy method is used to widen or lateralize the outer cortex of the cheeks. It is a two-dimensional cheek augmentation technique that increases facial or bizygomatic width. However, it can not increase anterior cheek projection. It has its value in certain aesthetic midfacial needs as well as in partial secondary correction of certain types of healed displaced cheekbone fractures. Its lack of creating a 3D effect limits its value for most aesthetic cheek augmentations.
Dr. Barry Eppley