Are there cases where revision surgery is possible with a 230-degree three-dimensional cheekbone reduction surgery?

Hello, this is Dr. Jo Hyun-woo of 입체성형외과.

Today, I will explain by showing the case of a patient who visited us with concerns about revision surgery for facial contouring, especially cheekbone revision surgery.

In fact, most people who want cheekbone revision surgery have similar concerns.

They often consider revision surgery when asymmetry in the cheekbones is still visible after surgery, when there is no visible effect from the front or side, or when there is no change in the width of the face.

Many people ask whether cheekbone revision surgery must always be done only with 3D cheekbone reduction surgery, or whether revision surgery can also be done with 230-degree three-dimensional cheekbone reduction surgery.

It is not 100% the case, but depending on the patient, some want a simple revision surgery, and in some cases, correction with 230-degree three-dimensional cheekbone reduction surgery is sufficient.

Before revision surgery

First, this patient came to us because they had undergone cheekbone surgery one year ago but did not see an effect from the front.

Looking at the CT images, there was almost no noticeable reduction from the front, and from below, only the right side cheekbone appeared slightly recessed.

Before revision surgery

In this patient’s case, we do not know what kind of surgery was performed previously, but surgery can be performed based on the first operation.

However, since there may have been an osteotomy in the side cheekbone area, it must be done carefully.

If you look at the CT images after surgery,

After revision surgery

You can see that the reduction is visible from the front, and from below, the recessed area secured with fixation pins is clearly visible.

After revision surgery

If you look at the patient photos after surgery, you can see that the side cheekbones have been reduced, and the overall cheekbone area looks smaller.

Before revision surgery

Next, this patient had cheekbone surgery four years ago and cheekbone revision surgery one year ago, but came in saying that the 45-degree cheekbone area was still protruding.

They did not want another surgery under general anesthesia, so we proceeded with shaving the 45-degree cheekbone area using 230-degree three-dimensional cheekbone reduction surgery.

Before revision surgery

As seen on the preoperative CT, if the fixation pin is located in the lower part, shaving can be performed with 230-degree three-dimensional cheekbone reduction surgery without removing the fixation pin.

After revision surgery

In the postoperative CT, you can see that the height of the 45-degree cheekbone has decreased.

After revision surgery

If you look at the photos after surgery, you can feel the difference before and after.

Before revision surgery

Lastly, this patient had cheekbone surgery seven years ago.

Looking at the CT images, there was nonunion in the 45-degree cheekbone area, and the posterior side cheekbone area had not receded at all and had recurred, so they came to us.

Before revision surgery

In general, this would be a case where the nonunion area is re-fixed with 3D cheekbone reduction surgery, and the side cheekbone area would need re-osteotomy and fixation.

However, the patient was very afraid of undergoing 3D cheekbone reduction surgery under general anesthesia.

So, after discussing with the patient, we did not re-fix the nonunion area because there was no pain, and instead performed 230-degree three-dimensional cheekbone reduction surgery, pushing the side cheekbone further inward and fixing it there.

After revision surgery

These are the CT images after revision surgery performed with 230-degree three-dimensional cheekbone reduction surgery.

This patient also wanted a little more change in the 45-degree cheekbone area, and on the CT images, you can see that it looks a bit smoother.

After revision surgery

When the side cheekbone is not recessed at all, pushing it inward like this can make the face look much slimmer.

In this column, I showed cases of cheekbone revision surgery performed with 230-degree three-dimensional cheekbone reduction surgery.

Of course, there are far more patients who undergo cheekbone revision surgery with 3D cheekbone reduction surgery, but if the case can be corrected simply, like those above, I think satisfactory results can be achieved with 230-degree three-dimensional cheekbone surgery alone.

Thank you.