A Detailed Explanation of the ‘230-Degree 3D Zygoma Reduction Surgery’ | Dr. Jo Hyun-woo, Stereoplasty Plastic Surgery

Hello, this is Dr. Jo Hyun-woo of Stereoplasty Plastic Surgery.

Today, I’d like to explain in detail the background behind devising the ‘230-Degree 3D Zygoma Reduction Surgery,’ along with the surgical process.

The type of contour surgery patients has changed over the past 10 years

When I first opened my clinic, it was the late 2000s.

A lot has changed over the past decade or so, and one of the biggest changes is the type of patients who come in.

In the late 2000s, contour surgery was mainly sought by people with very prominent cheekbones or square jaws.

However, in recent consultations, many patients do not actually have significantly developed facial contours.

I also feel that more people are considering surgery not because they truly need it, but because they want to refine areas that bother them.

The domestic surgical landscape before the 230-Degree 3D Zygoma Reduction Surgery was devised

There is a lateral cheekbone reduction procedure known to many of you as the ‘Quick Cheekbone Reduction Surgery.’

As the name suggests, Quick Cheekbone Reduction Surgery means performing cheekbone surgery quickly.

I think only each clinic knows exactly how they perform cheekbone surgery quickly.

There are methods that reduce only the lateral cheekbone through an incision at the sideburn area, cases where an intraoral incision is made but only shaving is performed, and cases where a complete osteotomy is done but no fixation is performed.

It seems that surgery is being performed under various methods using the name Quick Cheekbone Reduction.

I also perform a lot of 3D cheekbone surgery under general anesthesia, but I wondered whether there might be a simple yet effective way to reduce cheekbones for people whose cheekbones are not very large, so I reviewed many papers and came up with the ‘230-Degree Cheekbone Reduction Surgery.’

Quick Cheekbone Reduction Surgery is a procedure that reduces the protruding lateral cheekbone by cutting only the side cheekbone and pushing it inward.

Because there is no need for an intraoral incision, the surgery time and recovery period are short, so many people have sought it in recent years.

However, Quick Cheekbone Reduction Surgery had the problem of not reducing the 45-degree cheekbone.

More than 80% of patients who need cheekbone reduction also have a developed 45-degree cheekbone.

When such patients undergo Quick Cheekbone Reduction Surgery, they often remain completely unsatisfied even after surgery, which can lead to revision surgery.

For that reason, the 45-degree cheekbone could only be reduced with the standard 3D cheekbone reduction surgery.

3D cheekbone reduction surgery is performed by making an intraoral incision, completely cutting both the 45-degree cheekbone and the lateral cheekbone, removing part of the developed 45-degree cheekbone, then rotating the cut cheekbone inward and fixing it in place.

Why go through general anesthesia, an intraoral incision, bone removal, and fixation...

Ten years ago, I also only performed the traditional form of 3D cheekbone reduction surgery.

After consulting with patients over a long period, I came to understand that they commonly felt a significant burden regarding general anesthesia, and also disliked having fixation pins left in place because they would later need to undergo surgery to remove them. I learned that these points were inconvenient for them.

Over time, the types of patients who came in changed significantly as well.

As before, cases with very prominent cheekbones are rare. Even on CT scans, more than half of the patients only need minor refinement.

The 230-Degree 3D Zygoma Reduction Surgery began from the question of whether people who only need a little refinement really need to undergo surgery involving general anesthesia, an intraoral incision, bone removal, and fixation.

From the patient’s perspective, I thought it would be a clearly good alternative for those who find standard cheekbone reduction surgery burdensome, since it can be performed more safely without the burden of general anesthesia, cheek sagging, or fixation pins.

A detailed explanation of the surgical process

The 230-Degree 3D Zygoma Reduction Surgery is a procedure that uses the elasticity of the cheekbone.

The 45-degree cheekbone (No. 1) is partially osteotomized, and the lateral cheekbone (No. 2) is completely osteotomized before being pushed inward.

Up to this point, the surgical method is the same as Quick Cheekbone Reduction Surgery.

Then the 45-degree cheekbone would remain without being reduced.

While 3D cheekbone surgery removes part of the body of the developed 45-degree cheekbone, the 230-Degree 3D Cheekbone Reduction Surgery does not cut the 45-degree cheekbone; instead, it reduces it by smoothly shaving it down.

Before and after shaving the 45-degree cheekbone

The shaving process can maximize the effect on the 45-degree cheekbone area, which is not seen in Quick Cheekbone Reduction Surgery. By shaving, the cheekbone can be reduced by 2–3 mm.

This can be considered an effect that reaches more than 80% of what is achieved with traditional cheekbone surgery.

Saying that it has an effect reaching more than 80% does not mean that all cases are 20% less effective; rather, it means that when the 45-degree cheekbone is exceptionally developed, 2–3 mm may be somewhat insufficient. For such cases, I recommend 3D cheekbone surgery.

However, for most of the patients who visit, CT scans show that 2–3 mm is sufficient.

Over time after surgery, the pushed-in lateral cheekbone naturally fuses with the bone and becomes firmly fixed.

230-Degree 3D Zygoma Reduction Surgery without fixation (natural fusion)

Thoughts on fixation pins for cheekbone reduction surgery

The 230-Degree 3D Zygoma Reduction Surgery was also performed as a non-fixation method, but over the past 2–3 years, some patients have preferred fixation, and I also recommend fixation pins.

However, the number of patients who do not like seeing fixation pins on X-rays and therefore choose absorbable pins is increasing. The ratio seems to be about 33% non-fixation, 33% titanium, and 33% absorbable pins.

Posterior fixation in the 230-Degree 3D Zygoma Reduction Surgery

While titanium pins appear on X-rays like this

Posterior fixation in the 230-Degree 3D Zygoma Reduction Surgery (absorbable pins)

Absorbable pins do not appear on X-rays like this, as if there were no fixation, but they are firmly fixed.

Even when pin fixation is used, the surgical result is the same, but the bone hardens more quickly, so I think it is a good option for patients who are anxious about nonunion after surgery.

Before and after the 230-Degree 3D Zygoma Reduction Surgery

Before and after the 230-Degree 3D Zygoma Reduction Surgery

So far, I have explained the process by which I devised and performed the 230-Degree 3D Zygoma Reduction Surgery.

Rather than thinking, “Quick cheekbone surgery won’t do,” or “A non-fixation cheekbone surgery won’t do,” I believe that if you consider the accurately performed 230-Degree cheekbone reduction surgery, you can achieve sufficiently good results.

Thank you.

Rather than thinking, “Quick cheekbone surgery won’t do” or “Surgery without fixation pins won’t do,” I believe that if you consider a truly accurately performed 230-Degree cheekbone surgery, you can achieve sufficiently good results.

Thank you.