The Appropriate Choice of Zygoma Reduction Surgery Methods According to Face Shape

When considering surgery to reduce the contour of the cheekbones that define the midface, the most important point is,

"Which area should be reduced, and in what direction?"

The part I consider most important in zygoma reduction surgery is that,

while preserving facial dimension, the width of the face should become narrower,

and after the cheekbone contour has changed, there should be an expectation of a younger and more lively appearance.

Sometimes, during consultations, there are people who say they would like the cheekbone shape reduced so much that it almost disappears.

As the saying goes, too much of a good thing is as bad as too little,

I sometimes think we, who live busy and impatient lives, forget this very important truth.

In any case, people’s face shapes vary from person to person, and the areas that are more developed are often different.

Therefore, when performing surgery to reduce the cheekbone contour, I believe the most important thing is to choose a method that appropriately reduces the more developed area of the cheekbone.

Different face shapes require different approaches, so I believe there is some problem if the surgical method is always uniform.

First, when expressed accurately in medical terms,

the cheekbone is called the zygomatic complex (Malar Complex or Zygomatic Complex).

As the term complex suggests,

the cheekbone is composed of the malar body (zygomatic body) and the malar arch (zygomatic arch).

Looking at the faces of various people who want to reduce the contour of their cheekbones,

the body may be more developed in some cases, and the arch may be more developed in others.

Therefore, I think it is most ideal to choose the appropriate surgical method depending on which area needs to be reduced more.

I broadly divide cases of prominent cheekbones into two types when selecting a surgical method.

1. Cases in which the body of the cheekbone is developed (in the figure below, the area marked with the blue circle is the body of the cheekbone.)

2. Cases in which the zygomatic arch is flared outward (in the figure below, the area marked with the red circle is the zygomatic arch.)

 

When looking at the different shapes of the cheekbones from an upward-facing angle of the face, they are as follows.

From the CT images above,

in cases like the two examples at the top where the body of the cheekbone is developed,

I think it is appropriate to perform surgery by completely osteotomizing and fixing both the body of the cheekbone and the posterior part of the arch.

In cases like the two examples at the bottom where the body of the cheekbone is not prominent but the zygomatic arch is significantly flared backward,

I think it is appropriate to perform surgery by partially osteotomizing the cheekbone body, then completely osteotomizing the posterior part of the arch and bringing the flared zygomatic arch inward.

Below is a case in which the body of the cheekbone was developed, so both the body and the posterior part of the cheekbone arch were completely osteotomized and fixed.

Next is a case in which the zygomatic arch (cheekbone arch) was flared outward, and the surgery was performed by partially osteotomizing the body and completely osteotomizing the posterior part of the arch, which is the appropriate method in such cases.

In conclusion, depending on the shape of the face before surgery, and depending on which area the focus is placed on reducing, it is appropriate to choose the proper surgical method.

I will explain the advantages and disadvantages of complete osteotomy and partial osteotomy, as well as various cases, in more detail in a future post.