Q: Dr. Eppley, I am interested in cheekbone reconstruction. I had an injury to my right cheekbone 11 years ago it left my face asymmetrical. My right cheekbone is flatter now than the other side. It’s appears to be protruding at one point. The orbital looks out of place. I didn’t have insurance or money at the time to fix it so I allowed it to heal on its own. It obviously healed very poorly. I have not been happy with my appearance ever since. I was wondering what can be done to fix this and achieve a natural symmetry to my face I once had. I fear I may have broken the my zygomatic arch and since I didn’t fix it right away stuck with there results. I have gone to a few surgeons that recommended fillers although my cheekbone it flat in some areas that may help I’m concerned where it appear to protrude will upset that balance. I already have fairly large cheekbones and I don’t want them to appear larger. This is my concern about the filler. Most of the surgeons I went to downplayed the injury and were more interested in convincing me to live with it. This is not an option I’ve tried for 11 years and there hasn’t been a single day that I’ve been overcome by the disappointment in my appearance. This was never the case before the injury. I’m always researching and looking for surgeons that may be able to help. I saw you website and decided to make an inquiry. Thank you.
A: Thank you for sending your pictures. If I understand your concerns using the pictures as a guide, you have three right zygomatico-orbital concerns:
1) Right mid-zygonatic arch depression
2) Right posterior zygomatic bump (may just appear this way because the arch is indented)
3) flatter right inferolateral orbital rim-anterior zygoma
These three areas could be treated by cheekbone reconstruction consisting of the following :
1) small ePTFE zygomatic arch implant (max 3mms thick)
2) rasping down posterior zygomatic bump
3) small hand carved ePTFE inferolateral orbital rim implant
All done from inside the mouth.
Dr. Barry Eppley