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Cheekbone Reduction Surgery Before and After Surgery Photos

Homepage Star of November 2012
[ Author:Fushun Ma | Time:2012-11-24 17:48:45 |  Font Size: [Large Medium Small]
Tags: cheekbone reduction, cheekbone prominent, oversiz cheekbone, symmetric cheekbone

Cheekbone Reduction is one of the Cheekbone plastic surgeries. The oriental descendent have prominent cheekbone, so their cheekbone plastic surgeries are dominated by cheekbone reduction. The Caucasians have flat cheekbone, therefore their cheekbone plastic surgery is concentrated on cheekbone augmentation. The reduction surgery means to reduce the size of the cheekbone using various surgical techniques. While the augmentation means to make the cheekbone area big by introducing autologous tissue, such as auto bone graft or prosthesis, such as silicon implant.

Cheekbone reduction means to reduce the size of the cheekbone as stated in its name. Clinically this surgery may be done together with the zygomatic arch reduction because most patient with oversized cheekbone have oversized zygomatic arch too. Isolated cheekbone oversize is rare. The majority of the candidates have oversized cheekbone and zygomatic arch, only the cheekbone oversize may be more prominent. In this circumstances the reduction of the cheekbone alone may leave the oversized zygomatic arch stand out even more. It is better to treat the cheekbone and the zygomatic arch as a whole complex. The procedure of cheekbone reduction could involve cheekbone partial removal or cheekbone osteotomy depend on its thickness and the direction in which the cheekbone is augmented to. Bone filing was widely used for cheekbone reduction since many years ago. As this procedure needs an extended undermining the surgical trauma is relatively big. This technique has been substituted by cheekbone partial resectomy and cheekbone osteotomomy.

cheekbone reduction surgery
After cheekbone reduction the size of the cheekbone is smaller and two sides of the cheekbone are more symmetric. The temporal indentation is improved.

cheekbone reduction
Post surgically the zygomatic process is not prominent to the front lateral direction anymore and the facial outline is smoother. This lady also looks younger.

 cheekbone reduction chin up position
The augmentation of the cheekbone is less obvious and both side of the cheekbone is more symmetric.

Cheekbone resectomy is to remove the lateral cortex and part of the spongy bone, or the diploe for the facial flat bone, leave the inner cortex and a layer of the spongy bone overlaying on it in site. This technique is suitable for those who have thick cheekbone. As it is simple to handle, less traumatic and no internal fixation needed, cheekbone resectomy remains a good choice for suitable candidates. However for those whose cheekbone is thin, cheekbone resectomy is less effective because in this scenario extensive removal of cheekbone leads to cheekbone defect.

Cheekbone osteotomy cuts the front part of the zygomatic complex open, removes a slice of the bone, pushes the free bone inwardly and then fixes it back. This technique can be used in patients with thin zygomatic bone. The osteotomy line could be straight, in "L" shape or other irregular shape. The slice of the removed bone could reach the whole range of the zygomatic bone or only part of it, or the shape of the slice could be in wedged shape. However the zygomatic bone is a small bone(see Photos of the Zygomatic Bone), an average sized zygomatic is not much bigger than a coin. It is imaginable in none direct exposure, on this tiny surface the more complicated procedure the more unpractical and the end result is more unreliable.

After zygomatic bone osteotomy, especially after the removal of a slice of the zygomtic bone(without the removal of this slice the zygomatic arch can not be pushed inwardly), the repositioned zygomatic bone needs fixation to prevent possible dislocation. There are bunch of fixing techniques. The earliest way of doing it is the stainless steel wire fixation. Later on plate and screw fixation was introduced. Recently Dr. Fushun Ma uses tenon-and-mortise technique achieved more stable fixation without any foreign material left in the body.

photo analysis

Front view, this lady's face is a typical diamond shape with wide cheekbone, narrow forehead and narrow mandible bone. If we draw simple sketch lines along the facial outline we could get a diamond diagram (see pictures below). When comparing the two sides of the cheekbone the left side is way more bigger than the right side, giving an impression of that the middle face switches to the left side. Imaging the upper and middle face are two boxes respectively. Then the two boxes seemed not aligned and the middle box deviated to the left. After surgery the diamond shaped facial outline changed to a smoother one. Two sides of the cheekbone are more symmetric.

asymmetric high cheekbone correction
High cheekbone make a diamond shaped asymmetric face. The left side cheekbone is bigger than the right one. After surgery these problems improved.

The facial contour changes made by cheekbone reduction surgery can be best depict on the 45 degree angled front view. When a cheekbone is oversize the zygomatic process steak out lateral frontally. So the front view picture of a person with an oversized cheekbone or cheekbone dominated zygomatic bone and zygoamtic arch oversize looks ok, while the angled view will show the problem. Anatomically we call the outmost augmented point in the cheek area as zygomatic process point. This point's lateral frontal augmentation is the key character and diagnostic clue of cheekbone oversize. Some of the oversized cheekbone person come with a lower edge eversion of the zygomatic bone. As the lower edge of the cheekbone is low this everssion move the outmost augmented point to a lower level from the center of the cheekbone. The visual zygomatic process point shifted to a lower level to the lower edge of the zygomatic bone. This lower than normal arrangement of the zygomatic process point giving an impression of sagging face and aged look.

For this lady the sign of cheekbone oversize is obvious, the zygomatic process point thrust lateral and frontward. Her zygomatic process point is still in the center of the cheekbone, not in a lower level. Compare to the before surgery photo the oversized cheekbone has been corrected successfully in the post surgical photo. The zygomatic process point is less augmented and even lifted from the center of the cheekbone to the upper edge of the cheekbone approaching to the orbit. The upper edge of the cheekbone composes part of the orbit. Profound oversize of this part is rare and it is an area not suitable and also not easy reaching for surgery.

 In the picture below, the facial outline changed in a great deal after surgery. The degree of angle of ??ABC get bigger indicates that the degree of cheekbone augmentation is smaller. The distance between AB is shorter indicates that the zygomatic process point is lifted.  The size reduction of the cheekbone changed the face contour from a diamond one to a oval one, the lift of the zygomatic process point brought an upward change for the face. All these changes make the face of this lady looks younger.

change of the zygomatic process point after cheekbone reduction sketch of the zygomatic process point change
The surgery reduced the size of the cheekbone and lifted the zygomatic process point and finally made this lady looks younger.

In chin up position the big and high cheekbone augmentation changed to a flat surface and the two sides of the cheekbone are more symmetric.

The surgeries this lady underwent is Wedged Frontal End Ostectomy Zygomatic Bone Inward Movement and Zygomatic Arch Smooth Reduction. The post surgical photos were taken one year after surgery and she was satisfied with her post surgical result at that time already.

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