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Hello, this is Director Joo Hyun-woo of 입체성형외과.

Today, I’d like to explain in detail the reasons I came up with the ‘230-Degree 3D Zygoma Reduction Surgery’ and the surgical process itself.

The type of contouring surgery patient has changed a lot compared to the past

I opened my clinic in the late 2000s.

It has been more than a decade since then, and many things have changed, but one of the biggest changes has been the type of patients who come to see me.

In the late 2000s, contouring surgery was mostly sought by people with very pronounced cheekbones or square jaws.

However, these days, many of the people who come in for consultations do not actually have very prominent facial contours.

Rather than patients who truly need surgery, I feel that more and more people are seeking surgery to refine areas that they are concerned about.

The domestic surgical landscape before the 230-degree zygoma reduction surgery was devised

There is a side-cheekbone reduction surgery commonly known as ‘quick zygoma reduction surgery.’

Quick zygoma reduction surgery literally means performing cheekbone surgery quickly.

I think the method of how exactly the cheekbone surgery is done quickly is something known only by each clinic.

There are methods that reduce only the side cheekbones through an incision at the sideburn area, some that make an intraoral incision but only shave down the bone, and some that perform complete osteotomy but do not fix the bones. It seems that surgeries are being performed under the name of ‘quick zygoma’ in various ways.

Quick zygoma reduction surgery had the problem of not reducing the 45-degree cheekbone.

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

When such patients undergo quick zygoma reduction, they are often not fully satisfied even after surgery, and this frequently leads to revision surgery.

For that reason, the 45-degree cheekbone could only be reduced by performing a standard 3D zygoma reduction surgery.

3D zygoma reduction surgery is performed by making an intraoral incision, completely osteotomizing both the 45-degree cheekbone and the side cheekbone, removing part of the developed 45-degree zygomatic bone, and then rotating the osteotomized cheekbone inward and fixing it in place.

I also perform many 3D cheekbone surgeries under general anesthesia, but I wondered whether there might be a simple yet effective way to reduce the cheekbones for people whose cheekbones are not very large. After reviewing several papers, I came up with the ‘230-degree zygoma reduction surgery.’

Because there is no need for an intraoral incision, the surgery time and recovery period are shorter, so many people have chosen it.

Do we really need general anesthesia, an intraoral incision, bone removal, and fixation...

I, too, only performed the traditional 3D zygoma reduction surgery.

After consulting with patients for a long time, I learned that they commonly feel a strong burden from general anesthesia and are also uncomfortable with having to undergo another operation to remove fixation pins.

Over time, the types of patients who came to see me also changed significantly. Unlike before, patients with very prominent cheekbones are rare.

Even on CT scans, more than half of the patients only need refinement.

The 230-degree 3D zygoma reduction surgery began from the idea that if someone only needs a little refinement, is it really necessary to go through general anesthesia, an intraoral incision, bone removal, and fixation?

From the patient’s perspective, I believed it could be a safer option without the burden of general anesthesia, cheek sagging, or fixation pins, and that it would certainly be a good alternative for those who find regular cheekbone reduction surgery burdensome.

Detailed explanation of the surgical process

Method of 230-degree 3D zygoma reduction surgery

The 230-degree 3D zygoma reduction surgery uses the elasticity of the cheekbone.

The 45-degree cheekbone is partially osteotomized, and the side cheekbone is completely osteotomized, after which the side cheekbone is pushed inward.

Up to this point, the surgical method is the same as quick zygoma reduction surgery. In that case, the 45-degree cheekbone would remain without being reduced.

If, in 3D cheekbone surgery, part of the body of the developed 45-degree cheekbone is cut out and removed, the 230-degree 3D zygoma reduction surgery reduces the 45-degree cheekbone by smoothing it down through a shaving process without osteotomizing it.

45-degree cheekbone CT before and after shaving (1)

45-degree cheekbone CT before and after shaving (2)

The shaving process can maximize the reduction effect in the 45-degree cheekbone area that was not seen with quick zygoma reduction.

By shaving, the cheekbone can be reduced by 2–3 mm. This can be considered an effect equivalent to more than 80% of traditional cheekbone surgery.

The phrase ‘an effect equivalent to more than 80%’ does not mean that every case gets 20% less effect. It means that when the 45-degree cheekbone is unusually prominent, 2–3 mm may be a little insufficient. In such cases, I recommend 3D cheekbone surgery.

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

My thoughts on fixation pins for cheekbone reduction surgery

The 230-degree 3D zygoma reduction surgery was also performed without fixation, but many patients want fixation, and I also recommend fixation pins.

However, for people who do not like seeing the pins on X-rays, the number of patients choosing fixation with absorbable pins is increasing.

The ratio seems to be about 33% no fixation, 33% titanium, and 33% absorbable pins.

230-degree 3D zygoma reduction surgery (pin fixation)

While titanium pins appear on X-rays like this,

230-degree 3D zygoma reduction surgery (absorbable pin fixation)

Absorbable pins do not appear on X-rays like this, just as with no fixation, but they are securely fixed.

Even if the surgical outcome is the same, fixation allows the bone to heal more quickly, so I think it is a good option for patients who are anxious about nonunion after surgery.

Before and after 230-degree 3D zygoma reduction surgery (1)

Before and after 230-degree 3D zygoma reduction surgery (2)

Before and after 230-degree 3D zygoma reduction surgery (3)

So far, I have explained how I came to devise and perform the 230-degree 3D zygoma reduction surgery.

I believe that if you receive a properly performed 230-degree cheekbone reduction surgery, you can achieve sufficiently good results.

Thank you.