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Facial Sagginess After Cheek Reduction Surgery

[ Author:Fushun Ma | Time:2012-08-11 07:36:55 |  Font Size: [Large Medium Small]
Tags: facial sagginess, cheek reduction, zygomatic bone, zygomatic arch

Dear Dr. Ma, 

My name is Linda and I am 39 years old this year.  I have contacted a very experienced doctor in the field of bone contour specialty in terms of what I want to do to minimize the obvious part of my cheekbone which sticks out from the frontal view.  My right cheekbone is not as obvious as the left and I don't know if its a cause from several falls from standing on high rocks when I was just 5 - 6 years old.  What ever the reason for the asymmetrical it does not matter at this point but what really concern me is the warning I receive from this top surgeon that I will definitely experience sagging after the cheekbone reduction.  I would like to get your input on this matter because it is very important for me to know what my options are.  What is your diagnose of my cheekbone or if any?  What procedure do I need to achieve the look in my illustration?  Was it because of the particular surgery for what I want to achieve will cause skin sagging or because there is just no solution to treating me for what I want to achieve without some complication ie.  sagging.  I really feel helpless for wanting to achieve a"softer" look overall.  I don't want drastic change but just a subtle change to looks better.  Base on your writing (http://eng.plasticsurgerybeijing.com/quanguquangongzhengxing/quanxiachuima.htm) you mention several ways which will guarantee skin sagging after zygomatic reduction, are the front and rear cutting of the bone is what I need in order to achieve the looks I want?  Is there other technique which could apply to avoid skin sagging in my case?

I want to get your input on my goal and see if they aligns with this other specialist.  Would it be possible to just shave the bone abit instead of cutting them?  Will that help to reduce the sagging?  Additionally I am also afraid to let people know that I have done surgery since people in the Western world really look down upon those who have had it.  What is your input of the time to recover and look normal to go back work/normal routine?

Attached are the pictures of recent photo and I also try to use the software on my computer to do an assimilation of how I look after the reduction in one photo. 

Looking forward to hearing back from you on your feedback.



Dear Linda,

Thank you for your letter. It is difficult to diagnose the reason for facial asymmetry let alone just some description and a photo. But most of them have no reason. However before surgery I need a detailed CT scan to rule out any bone problems that could prevent the surgery.

Regarding your biggest concern of sagginess you already read my webpage talking about it. Briefly speaking the old methods of surgery tend to cause sagginess. There are a lot of surgeons who tried hard to find ways to avoid this complication. I am one of them and actually I provided a new method of surgery call combination osteotomy cheek reduction which solved this problem more than ten years ago. See my doctorate thesis. Now this method has been modified in term of incision and undermining to reduce surgical trauma. And also the way of bone osteotomy has been modified to avoid internal fixation. Till now I hardly see any sagginess in my post cheek reduction patients. You know in medical field there is no guarantee. As a surgeon I can’t guarantee that there is definitely no sagginess in my patient. However the rate of this complication is really low.

The facial sagginess is caused partially by the cutting of the bone and partially by the undermining of the soft tissue. So even you just file the bone without cut it there is a possibility of sagginess if the surgeon didn’t do it properly.

For the recovery time it varies in different people. Normally at the end of three weeks post surgery patient could go back to work without notable changes. Most of my patients discharge in 3 days, go back to work in one week or ten days with some swelling.

I saw you photo and you simulation. That is a conservative charge you desiring. Technically we can achieve much big different. But that is your call to do it conservative or radical.

Best regards,

Fushun Ma

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