Back Cheekbone Shaving? Osteotomy? Do You Really Need It?

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

Lately, more and more people have been saying that when they undergo cheekbone reduction surgery, they also want the back cheekbone removed.

I once wrote a column about back cheekbone shaving.

As mentioned in that column,

not all patients need back cheekbone osteotomy or shaving.

In the cheekbones of most patients, when the outer cheekbone is moved inward, it comes to lie almost on the same line as the back cheekbone, so the back cheekbone does not look more prominent.

The shape of a typical cheekbone

However, for people whose bone gets wider toward the back, the back cheekbone may become very visible after surgery.

A bone shape that becomes wider in the back

In such cases, I explained a method for addressing the bone in the back cheekbone area by removing the fixation pins after the bone has fully healed and then shaving the back cheekbone.

A case in which back cheekbone shaving was performed after 230-degree three-dimensional cheekbone reduction surgery (with absorbable pin fixation)

In my case, if osteotomy is not something I am accustomed to, the skull bone could be at risk, so I prefer the shaving method.

However, recently, it seems that there are many people who want to address the back cheekbone at the same time as the surgery.

If the back cheekbone bone is osteotomized and pushed inward, it looks like this before the fixation pins are used.

If the back cheekbone area is carefully shaved,

It can be shaved down by about this much.

If too much is shaved, the pins may not be fixed securely, and there may also no longer be any area left for bone fixation, so the amount must be carefully adjusted and shaved only to an appropriate degree.

Then it is fixed with a straight plate like this.

This reduces the visibility of the back cheekbone area and makes it form a straight line with the cheekbone line.

I will show you the CT images of a patient who had surgery as described above.

A patient who wanted shaving of the right back cheekbone and further inward movement of the left cheekbone, as well as back cheekbone shaving, after surgery at another hospital; a case in which the right back cheekbone was shaved, the left cheekbone was re-osteotomized and the back cheekbone was shaved, and then fixed with a straight plate

However, as mentioned earlier, because there is a possibility that the fixation may not be secure, it must be done carefully.

When I operate on many patients, it seems that only about 1–2 people a year request shaving because of the back cheekbone.

If done accurately, I think back cheekbone shaving or osteotomy is a surgery that can produce good results without needing a second operation.

However, since it may be something you would not feel at all even if you did not specifically do it, it would also be a good idea to understand the shape of your own cheekbones and try to predict the future result in advance.

Today, we looked at back cheekbone osteotomy and back cheekbone shaving, which many patients have been asking about lately.

This surgery is not essential; if you carefully judge whether it matches your own case and proceed accordingly, you may be able to achieve good results without unnecessary burden.

Thank you.