Cheekbone reduction surgery is a common procedure in Asian facial reshaping. A variety of techniques have been described to reduce prominent cheekbones which consists of anterior zygomatic osteotomies and posterior zygomatic arch osteotomies to move the width of the cheekbones inward. While effective for many patients it does not treat the complete skeletal problem which can extend upward into the lateral orbital rim as well as the overlying position of the lateral canthal angle.
In the June 2019 issue of the journal Aesthetic Plastic Surgery an article was published entitled ‘Lowering Lateral Canthoplasty and Orbital Rim Shaving: An Ignored but Necessary Procedure for Maximizing the Effect of Reduction Malarplasty in Asians’. In this paper the authors describe a technique for improving the aesthetic outcome of standard cheekbone reduction surgery (intraoral and preauricular approach) that includes reduction of the orbital rim and lowering of the lateral canthal angle. Through a lower eyelid incision and canthotomy the inferolateral orbital rim was shaved off with inferolateral repositioning of the lateral canthus. The results in 17 patients were assessed using cheek surface area measurements by computer analysis.
Before and after surgery measrements showed an average decrease in surface area from around 23,000 mm2 to around 19,000 mm2. (18.5% decrease) The upper slanting eye corner was lowered and the protruding cheekbone and infer lateral orbital rim reduced in all cases. Four complications occurred asymmetry (2) and wore eyelid malposition. (2)
The simultaneous lowering lateral canthoplasty and inferolaterial orbital rim shave offers an enhanced facial slimming effect to cheekbone reduction surgery in select Asian patients. The risks are that of lower eyelid malposition and adverse scarring which are additional risks of any lower eyelid procedure.
Dr. Barry Eppley