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Facial Sagging After Zygoma Reduction Surgery

[ Author:Fushun Ma | Time:2011-10-20 09:49:58 |  Font Size: [Large Medium Small]
Tags: facial sagging, zygoma reduction, zygomatic arch reduction

Does facial sagging occur after every zygma and zygomatic arch reduction surgery? This is a frequently asked questions during Dr. Fushun Ma's consultation with facial reduction surgery candidates. The answer is "NO".  Most methods of the zygoma and zygomatic arch reduction surgery will not cause any facial sagging. However same reduction methods such as the Front End or the Front and Rear End Osteotomy Zygoma Reduction tend to have a sagging face complications.  This is why facial sagging caught a lot attention.

Facial sagging after zygoma and zygomatic arch reduction surgery indicates the deep tissue and muscle prolapsus in the cheek apple area caused by the downward displacement of the zygoma and the zygomatic arch bone after the zygoma reduction surgery. This kind of facial sagging is difficult to correct. So it is very important to avoid its happening. The facial sagging cause by zygoma surgery is deferent from the aging changes of the face in many ways. In aging face the skin wrinkles and loose skin are the most prominent features while the deep tissue change is secondary. Swelling around the nasal labia fold and tear droop shape cheek apple at smile are not common as the deep tissue drop less than the skin in aging process.

Why is zygoma and zygomatic arch reduction not normally associated with facial sagging? As mentioned earlier facial sagging is common among specific operation methods and also related with malpractice during the surgery. It is to say if a improper surgical method is chosen and/or malpractice exist during the surgery facial sagging may happens. Most of the other surgical methods for zygoam reduction will not tend to cause any facial sagging. Dozens of surgical methods are been utilized in zygoma reduction till now. Only the Font End Osteotomy Zygoma Reduction Surgery and the Front and Rear End Combined Osteotomy Zygoma Reduction Surgery are known to have a high facial sagging rate. In terms of operation handling such as over undermining, over severance of facial tendon and improper post operative bandage are factors that will increase the possibility of facial sagging. However even all the unfavorable factors toke place in one patient he or she may not for sure get the facial sagging, only his or her chance of facial sagging is greater than normal. So we say the zygoma reduction surgery is not definitely associated with facial sagging.

no sagging after face reductionno facial sagging after facial bone reduction
More than on year after filing reduction surgery of the zygoma and the zygomatic bone, the girl didn't feel any change on her cheek area and there is no facial sagging noticeable. On secondary surgery evidence of massive undermining during the first operation is found on both side. Massive undermining alone did not cause facial sagging for this girl. It is discovered after many cases of facial bone reduction that in simple bone filing procedure though the undermining is massive facial sagging may not happen because the structure of the bone frame is intact.

Why do the two surgical methods mentioned above tend to have facial sagging? When using these two methods the front end or both the front and rear end of the zygomaitc arch complex will be severed from their attach base and then a inward push of the mobilized bone is done to make the face narrower. In these processes the structure of the strong front end of the zygomatic complex is damaged and the inward pushing will also move the bone and its attaching soft tissue downward. Thus the facial sagging happens. On the other hand as the most prominent zygoma point is pushed inward and downwardly the attaching muscle and deep tissues also following this movement cause the facial sagging. Sagging caused by over undermining and over severance of tendons will not affect the bone. In these instance the happening of facial sagging (if any) is due to the miss reattachment of the muscle and tendons. The displaced lower reattachment of the muscle and other soft tissues contributes to the facial sagging.

zygoma bone zygomatic arch and expression muscleszygomatic bone and zygomatic arch sagging
The expression muscles are attached at the surface of the zygomatic bone and zygomatic arch. When these bone is dislocated downwardly the origin of the expression muscles move downwardly too causing the muscles disfigure, sagging and distortion. The cheek apple sagging and swelling around the nasal labia fold also can be noticed.

Restoration of the post zygomatic reduction bone and tissue sagging is difficult. In order to correct the sagging the bone and muscles themselves must be relocated to their original place. Facelift and skin tightening will not help the sagging bone and muscle to relocate. In practice Dr. Fushun Ma encountered many patients with post zygomatic reduction sagging underwent facelift and various kind of skin tightening failed to eliminate the sagging and swelling look. Some zygomatic reduction surgery seekers asked Dr. Ma if a zygoma reduction combined with a facelift surgery will prevent the sagging from happening. This combination of surgeries is also not reliable. The intro-operation lift include skin lift and deep tissue lift. As mentioned earlier the skin lift does not work. The deep tissue lift does not work too because the repeated deep muscle movement will tire off any kind of fixation used in the lift no matter its suture or screw. So no deep lift will last long in this scenario.

The easy preventable facial sagging caused the improper post operation bandage is often been neglected. The tighter bandage for zygomatic reduction surgery is not the better. If the bandage is too tight the muscles and soft tissue may by squeezed downward into the inferior zygoma fossa causing sagging. This kind of sagging can be easily prevented by using facial wear with proper size, proper elasticity and tension to provide a recoiling force in helping the muscles to reattach on the bone in the right position.

In summary the post zygomatic reduction facial sagging is a complication which is difficult to correct. It is more than important to choose the right operation method, handle the operation in a right way and nurse the surgery site properly. Once the sagging happened be sure to see a surgeon and discuss the situation, seeking earlier restoration surgery if possible. In most cases a restoration surgery will help to eliminate the sagging in a great deal.

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