After zygoma reduction surgery, the cheek sagging is severe — is it because of dissection?

Hello, this is Director Jo Hyun-woo of 3D Plastic Surgery.

When people think of zygoma reduction surgery, one of the side effects that comes to mind is cheek sagging.

I have discussed cheek sagging through several columns.

Today, I’d like to explain the extent of dissection in a little more detail.

First, dissection is a surgical process that determines the scope of the operation.

The same process is also necessary in eye or nose surgery.

In the case of nose surgery, after the incision, the dissection is performed to create the space where the implant will be inserted and where the tip cartilage will be placed.

However, when people undergo nose surgery or breast surgery, no one says that making the dissection wider will cause the nose or breasts to sag. Why is that?

The answer lies in whether the surgery reduces volume or increases volume.

In nose surgery or breast surgery, after dissection, an implant is inserted, increasing volume within the dissected area.

Therefore, there is no room for the skin to sag.

But contour surgery is a surgery that reduces volume.

If dissection is performed and the zygomatic bone is reduced, there will clearly be more empty space than before.

The more it is reduced, the more space there will be.

As a simple example, let me show you a balloon.

When air is let out of a balloon that is fully inflated, the outer surface of the balloon naturally becomes wrinkled.

Likewise, in contour surgery, when the zygomatic bone is reduced, there will inevitably be remaining soft tissue, and as a result, the excess skin may appear to sag outward.

Of course, depending on the case, people with more facial fat or skin that stretches well may feel sagging more, and in such cases, thread lifting or laser lifting treatments may be needed after surgery.

To prevent this kind of cheek sagging, a process is needed to reduce the room for the skin to sag, and that is the process of narrowing the dissection range.

I will explain the dissection range using the examples of 3D zygoma reduction surgery with an intraoral incision and 230-degree 3D zygoma reduction surgery with a scalp incision.

The red area in the illustration is the minimum dissection range required for 3D zygoma reduction surgery.

Since the surgery requires an intraoral incision and removal of the 45-degree zygomatic bone, even the minimum dissection range becomes the red area shown here.

Of course, if the dissection is made wider, the surgery becomes easier and simpler, but to reduce cheek sagging, it is better to minimize the dissection range as much as possible.

This blue area is the dissection range for 230-degree 3D zygoma reduction surgery, which is performed through a scalp incision.

Because it is not an intraoral incision, the dissection range is limited to only the area where partial bone cutting and shaving will be performed.

Many people ask about this.

"Because surgery with a scalp incision has a wider dissection range, doesn’t it cause more skin sagging?"

However, although this depends on the surgical method and the surgeon performing it, in my case the dissection range is much smaller with 230-degree 3D zygoma reduction surgery.

Of course, a wider dissection can allow more extensive shaving, but because surgery is about gaining one thing and losing another, rather than widening the dissection range to do more shaving, I perform the surgery in a way that minimizes dissection to reduce sagging.

I have marked the dissection ranges of the two surgeries.

The red area is the dissection range for 3D zygoma reduction surgery, so the difference should be easy to see.

3D zygoma reduction surgery, square jaw surgery, 1 year follow-up

When the cut zygomatic bone is not properly fixed, or when the bone is cut or dissected more than necessary, sagging can occur.

In such cases, it may not be felt immediately after surgery, but as early as 6 months later, cheek sagging can become noticeably worse.

230-degree 3D zygoma reduction surgery, 1 year follow-up

Therefore, among all things, zygoma reduction surgery must be performed accurately in order to minimize cheek sagging.

If you receive surgery from an experienced and skilled specialist and understand that the degree of sagging can vary depending on the surgical method, you may expect better results when you go for a consultation.

Thank you.