Dr. Ma Plastic and Cosmetic surgery logoDr. Ma Plastic and Cosmetic surgery

Zygomatic Bone and Zygomatic Arch Displacement and Defect After Frontal End Osteotomy

[ Author:Fushun Ma | Time:2011-10-20 09:53:07 |  Font Size: [Large Medium Small]
Tags: comlication of zygoma reduction, displacement of zygomatic complex, bone defect

One of the relatively severe complications is the displacement and defect of zygomatic bone and zygomatic arch after zygoma reduction surgery. It related to the improper surgical plan, improper practice during the operation and the structure or density problems of the bone. This kind of complication composed a high portion in the revision surgery after zygomatic bone and zygomatic arch reduction surgery. This complication is very common among the Frontal End Osteotomy Zygomatic Bone and Zygomatic Arch Reduction Surgery as it rotates the zygomatic complex downward while pushing it inward to narrow the face. The right side zygomatic complex in the following CT images displaced downwardly after reduction surgery.

downward displacement of the zygomatic bone and zygomatic arch after surgery 3D CT image of the zygomatic complex
The right zygomatic complex displaced downwardly after reduction surgery. The points indicated by the arrows should have jointed together foming a normal zygomatic complex in the left side image. Compared to the right side image the zygomatic complex in the left side image is greatly displaced downwardly. This arrangement may interfere the normal jaw movement.

downward displacement of the zygomatic complex after surgery CT image of the zygomatic bone and zygomatic arch
The displacement of the zygomatic complex in another angle of view. The CT image show that the zygomatic complex displaced downward and inwardly.

defect of the zygomatic complex after reduction surgery CT image of the left side zygoma
Bone defect after zygomatic bone and zygomatic arch reduction surgery. The arrows show a gap on the zygomatic arch and the zygomatic bone to the front of the arrows is thinner compared to the right side image.

The displacement of the zygomatic complex is quite severe in the images shown above. Most frequently the displacement can't reach that far. If the patient is young and the facial fat is thick even the zygomaitc complex is already displaced there may be no signs of deformity on the face beside some soft tissue sagginess. The defect on the bone will show soon after surgery on skinny patients or on patients who have already done the operation for many year. For some patients the temporal muscle movement may be seen on the zygomatic area if the bone coverage is removed by the reduction surgery. Dr. Fushun Ma call this kind of movement the Temporal Muscle Movement Reveal Syndrome.

Displacement and defect may happen asymmetrically. In this case the left side mainly has bone defect while the right side mainly displacement. Under this situation the frontal end of the zygomatic complex lost connection to the other facial bones. The zygomaitc complex hangs on the face by only a very thin connection at the rear end of the zygomatic somplex. The rear end osteotomy line could become a pseudoarthrosis if the healing process is interfered by facial muscle movement. The displaced zygomatic complex can than move under force. When the displace bone is pushed by a hand a movement can be felt with or without light cracking sound around the pseudoarthrosis. In severe displaced patients the lower jaw motion may be interfered and a mouth open limitation may occure.

For information regarding zygomatic bone and zygomaitc arch displacement and defect see "Revision Surgery After Zygomaitc Bone and Zygomatic Arch".

[Next]Complications of Zygomatic Bone.. [Previous]Photos of High Zygoma and Zygom..
Related Pages
New Pages
Hot Pages