Does Facial Contouring Surgery Always Require All 3 Procedures? Cases Where Zygoma Reduction Surgery Alone Can Create a Smaller, Smoother Face

These days, as people prefer smaller, more delicate-looking faces, many want to improve their facial shape through facial contouring surgery. While the eyes and nose are important factors in first impressions, it can be difficult to create a refined and soft impression if the facial outline that surrounds them is not harmonious.

Facial contouring surgery can generally be divided into three types: square jaw reduction, chin reduction, and zygoma reduction. Depending on the facial contour structure, all three procedures may be necessary in some cases, but in the case of Asians, the cheekbones are often relatively prominent, so zygoma reduction surgery alone can sometimes improve the face into a smaller and slimmer shape. In particular, we will take a closer look at which cases show the effects of zygoma reduction surgery most clearly through actual patient cases.

A patient with prominent 45-degree and side cheekbones, making the cheekbones stand out

TS Plastic Surgery zygoma reduction surgery performed / before surgery - 2020.06.26

In this patient’s case, the 45-degree and side cheekbones were especially developed, and when viewed from the front, the cheekbones appeared more prominent than the jaw. In such cases, even without additional square jaw surgery or chin reduction surgery, zygoma reduction surgery alone can be expected to make the face appear smaller.

Also, because the cheekbones were noticeably protruding and more prominent than the temples and the area below the cheekbones, this can be considered a case where zygoma reduction surgery could produce a greater improvement.

TS Plastic Surgery zygoma reduction surgery performed / before surgery - 2020.06.26

The cheekbone area can largely be divided into the front cheekbone, 45-degree cheekbone, and side cheekbone. Among these, when the front cheekbone is wide and lacks volume, the face can appear large and flat. Therefore, reducing the area of the front cheekbone while maintaining a certain amount of volume helps create a more balanced facial shape.

1. Reduction of the 45-degree cheekbone and side cheekbone

Source: TS Plastic Surgery website

The surgery is planned in a way that safely protects the nerve line and places the resection area close to below the eye, sufficiently reducing the front cheekbone area. Because the resection area takes on a trapezoidal shape, this is also called a 'trapezoid osteotomy,' and the cheekbone moves inward by the amount that is removed. Through this, the distance between the eyes and cheekbones becomes narrower, and a reduced sense of empty space can be expected. In addition, as the 45-degree cheekbone is reduced and moves inward, the protruding area can be seen to become smoother.

TS Plastic Surgery zygoma reduction surgery performed

2. Rotation for side cheekbone reduction

Source: TS Plastic Surgery website

When moving the cheekbone inward to reduce the side cheekbone, the process of rotating it while moving is important. If the procedure is done by simply pushing it inward, the surgical effect may be limited. However, when the cheekbone is moved inward with rotation, position adjustment is possible, so improvement can also be made in cases with left-right asymmetry. In addition, when it is moved inward while rotating, tissue gathers toward the front cheekbone area, and a natural sense of volume can be expected. Proper volume in the front cheekbone can help give the face a more lively and three-dimensional impression.

TS Plastic Surgery zygoma reduction surgery performed

3. Double fixation

In zygoma reduction surgery, one of the most important factors after reduction is 'fixation.'

Fixation is not simply about maintaining position; it can also help prevent side effects such as nonunion and affect how well the reduction effect is maintained. If you do not feel the expected change after surgery, or if the cheekbones seem to widen again over time, it is necessary to check the fixation status.

In fact, even if the cheekbone is moved by about 5 mm, if the fixation is not sufficient, the bones may separate due to the movement of the chewing muscles, reducing the intended reduction effect. Therefore, strong fixation is very important.

Source: TS Plastic Surgery website

A double-fixation method using both plates and wires is a way to improve stability.

Double fixation can help prevent side effects such as nonunion or sagging of the cheeks, and it can also help maintain the surgical effect by preventing the bones from widening again. In addition, because stable fixation makes it easier to encourage opening exercises during recovery, the recovery speed may also be positively affected.

Source: TS Plastic Surgery website

Wire fixation is a method of tightly securing both sides of the bone by wrapping them, helping the cut bones come together more closely and fuse stably. Compared with fixation using plates alone, it has the advantage of providing a stronger hold. However, because it is a highly difficult procedure performed through a narrow incision inside the mouth, delicate surgical skill is required.

In addition, for areas where load is concentrated, such as the body of the zygoma, a method of strong double fixation tends to favor a scalp incision over a separate sideburn incision fixation. The scalp incision is made at about 1–2 cm in size to minimize damage to hair follicles, and after recovery, the scar is not exposed and is naturally covered by hair.

TS Plastic Surgery zygoma reduction surgery performed

The person introduced today is a case in which only zygoma reduction surgery, among facial contouring procedures, was performed alone. Before surgery, the protruding cheekbones were noticeable and gave a somewhat strong impression, but after surgery, the prominence of the cheekbone area was softened and the contour line was neatly refined, resulting in a more natural and feminine image.

In particular, when the head shape is not large, there is little facial fat, and the bone size is relatively large, the changes after zygoma reduction surgery can be even more pronounced.

Because the face is a structure in which not only bone but also muscle and fat tissue act together, it is important to accurately understand each individual’s condition through preoperative CT scans. Based on the examination, if you consult sufficiently with an experienced medical team and make a plan, you can prepare for surgery more carefully.

※ Side effects such as inflammation, bleeding, and nerve damage may occur depending on the individual, so sufficient consultation with the medical team is necessary before surgery.