Is 230-Degree Three-Dimensional Cheekbone Reduction Surgery Better Than Standard 3D Cheekbone Surgery?

Hello. I’m Dr. Jo Hyun-woo of Stature Plastic Surgery.

Generally, people with prominent cheekbones often undergo cheekbone reduction surgery through an intraoral incision, commonly referred to as 3D cheekbone surgery.

3D Cheekbone Reduction Surgery

This is the most common surgical method, in which part of the 45-degree cheekbone is removed and the posterior arch portion of the cheekbone is osteotomized and rotated inward.

At present, this is the method that most effectively rotates the bone inward and reduces volume the most.

At Stature Plastic Surgery, we perform not only this 3D cheekbone surgery, but also a procedure called 230-degree three-dimensional cheekbone surgery.

This time, let’s take a look at how 230-degree three-dimensional cheekbone surgery is better than the existing 3D cheekbone surgery.

230-Degree Three-Dimensional Cheekbone Reduction Surgery

230-degree three-dimensional cheekbone surgery is a method in which, instead of an intraoral incision, a scalp incision is made to partially osteotomize the bone in the 45-degree area, and the posterior arch bone is osteotomized and rotated inward.

So, what advantages does this surgical method have compared to 3D cheekbone surgery?

1. The surgery can be performed under sedation anesthesia.

Because the surgery is not performed through an intraoral incision, general anesthesia is not necessary, and it can also be performed under sedation anesthesia.

General anesthesia is used in common contouring surgery because securing the airway can prevent irrigation fluid or blood from entering the mouth.

Since 230-degree three-dimensional cheekbone surgery uses a scalp incision, there is no need for separate airway management, and the procedure can be performed safely under sedation anesthesia.

2. The surgery time is shorter.

In general, a shorter surgery time can lead to a faster recovery.

Even for the same procedure, if it is performed more quickly, there may be less postoperative swelling, and less swelling naturally allows for faster recovery.

I do not think that simply being fast is always good, but if the surgery is performed accurately, then of course a surgery that ends sooner is better than one that takes a long time.

3. The dissection range is smaller.

230-degree three-dimensional cheekbone surgery requires less dissection than cheekbone surgery performed through an intraoral incision.

Because the dissection range is smaller and the extent of cutting muscles or damaging tissue is very limited, the likelihood of postoperative cheek sagging or other complications is naturally lower.

4. There is less pressure on the masseter muscle.

This is the first time I am mentioning this on my blog.

Based on my recent observations of patients with large temples, the masseter muscle runs beneath the cheekbone.

In standard 3D cheekbone surgery, the 45-degree bony portion rotates inward.

Therefore, all the bone from the 45-degree area to the arch area ends up pressing on the masseter muscle.

If a patient has a large masseter muscle, then when the cheekbone is reduced, the masseter can be compressed, and the temple area may become prominently bulged.

In people whose temples are already sunken, the feeling of protrusion after surgery is naturally less noticeable, and the temple area may actually look better as it regains some volume.

However, in people whose temples are already prominent, only the temples may appear even more bulged after surgery.

Therefore, for such patients, 230-degree three-dimensional cheekbone surgery may be more suitable than 3D cheekbone surgery.

In my personal opinion, 230-degree three-dimensional cheekbone surgery causes much less compression because it does not push the 45-degree cheekbone inward and instead performs shaving on the outer side.

5. It is possible to perform the surgery without visible fixation pins.

In 230-degree three-dimensional cheekbone surgery, the 45-degree cheekbone is not fully osteotomized; only the posterior arch portion is osteotomized, so only the arch area needs to be fixed.

For fixation in the posterior arch area, absorbable pins can be used.

I believe absorbable pins are somewhat weaker than titanium pins, so I avoid using absorbable pins in the 45-degree area and use them only for fixation in the posterior area. When fixation is done with absorbable pins, the pins do not appear on X-ray or CT, making it possible to perform cheekbone reduction surgery without visible pins.

Use of absorbable pins in the arch area

Of course, 230-degree three-dimensional cheekbone surgery is also a procedure that can be performed without using any fixation pins at all.

Because the surgery can be performed without pins, I think this can be a very big advantage.

6. There is less scarring, and eating is easier.

Of course, cheekbone surgery performed through an intraoral incision does not leave a visible scar from the outside, but that does not mean there is no scar at all.

Because the incision is made inside the mouth, you also need to keep gargling, and eating may be inconvenient.

However, because 230-degree three-dimensional cheekbone surgery uses about a 1 cm incision on the scalp, it can be performed without being visible from the outside at all, and there are no restrictions on eating. Therefore, if eating is important to you, it can be a good alternative.

7. There is no possibility of nonunion.

230-degree three-dimensional cheekbone surgery does not involve complete osteotomy of the bone; it involves partial osteotomy, so nonunion cannot occur.

Nonunion can cause cheek sagging and pain, so it must be carefully avoided.

A properly performed 230-degree three-dimensional cheekbone surgery can fundamentally prevent this possibility, so it can be considered safe.

8. There is no possibility of sinusitis.

Because 230-degree three-dimensional cheekbone surgery does not open the sinus through osteotomy, it can fundamentally block the possibility of sinusitis caused by the surgery.

Of course, even with 3D cheekbone surgery, the likelihood of sinusitis occurring is extremely low, but this can be considered a way to preemptively prevent any possible sinusitis.

So far, I have explained about eight ways in which 230-degree three-dimensional cheekbone surgery may be better than 3D cheekbone surgery from my point of view.

However, I think different doctors may have different opinions.

It is an undeniable fact that 3D cheekbone surgery reduces the cheekbone more than 230-degree three-dimensional cheekbone surgery.

Therefore, despite these various advantages, I think patients who want to reduce the cheekbone as much as possible should choose 3D cheekbone surgery.

Contour surgery is a procedure that is difficult to easily undergo revision surgery after it has been performed, so before surgery, it is important to think carefully about how the surgery will be done. Therefore, if you choose the surgery that is right for you, I believe you can achieve a more satisfying result.

Thank you.