Wide Zygoma and zygomatic arch contribute to a diamond shipped facial appearance, rough facial outline and disproportional facial contour.This situation increases with age. As the facial soft tissue shrinking, temporal and cheek getting depression the zygoma and zygomatic arch protrude more obviously to the lateral. There are two options to change this situation. For those who already have a elongated shaped face, in particular those whose contour problem was caused by aging, the best choice is autologous tissue transplant such as fat transferring. For those who have a wide face on top of that a prominent zygoma and zygomatic arch the best choice is malar reduction surgery.
Front view of the protruding zygoma and zygomatic arch. The whole face is in a diamond ship. The midface is wide with a sticking out zygomatic arch blocking the view of the ear lobe. From the 45 degree angle view of the protruding zygoma and zygomatic arch. The zygoma area has a highlight reflection spot. The facial outline at the zygoma area is protruding.
Zygoma reduction plasty is for high cheek bone reshaping. The characteristic facial appearances of high cheek bone include the frontal lateral protruding of the cheek and the facial outline is curved too much at the cheek area at the 45 degree profile angle. Zygomatic arch reduction plasty is for reshaping the protruding zygomatic arch. The characters of zygomatic arch protruding include bulging at the front of the ear from the front view and the cheek outline curved laterally from the lateral rear view angle. Using a hand touching the skin of the temporal area and sliding down along the side of the face we can feel the bulging of the protruding zygomatic arch. For people whose zygomatic arch is not protruding we can feel the bulging on the face even their face may be wide. The author often use this method to understand the zygomatic bulging and symmetry. For more accurate analysis we need CT scan of the maxillofacial bone. The author ask the zygomatic reduction plasty patient to do CT scan and 3D reconstruction CT analysis routinely.
Like other plastic surgery, not every people can be a good candidate for zygoma and zygomatic arch reduction surgery. A solid indication is very important for a satisfied outcome. If the indication is not conformed for the surgery the result facial contour could be wired. So, what kind of people fit zygoma and zygomatic arch reshaping? Every body could easily answer "those who have a prominent zygoma and zygomatic arch of course". However, how to define a prominent malar? What is the amount to be reduce? Those are questions which need more complicated answers. So we need some kind of investigations
There are contraindications for zygoma and zygomatic arch reduction plasty such as poor health condition, anesthetic intolerance, anesthetic agent allergy, local inflammation and tumor, long term anticoagulation therapy and other situations not suitable for surgery. It is better not to do surgery during the menstrual period.