Can My Facial Asymmetry Be Improved With By Reduction of the Zygomatic Process of the Temporal Bone?

Q: Dr. Eppley, I have a question about the zygomatic process of the temporal bone (I believe that’s what it’s called—I’m referring to the bone on the side of the head that connects the ear to the cheekbone). For me, my face is asymmetrical in that it’s wider on the right side of my face than my left. I was wondering if there’s any procedure to thin the bone a few mm and improve symmetry. I have read several posts by you and I believe it is called a posterior zygomatic arch osteotomy.

Thank you.

A:Thank you for your inquiry. You can reduce the prominence of the temporal process of the zygomatic arch. (or the zygomatic process of the temporal bone….depending upon how one chooses to call it) I have done so many times. This is technically called a posterior zygomatic arch osteotomy. This is done by an angled osteotomy with plate and screw fixation to hold the cut bone inward. This is done through a small vertical skin incision at the back end of the sideburn hair in front of the ear.

A very relevant question is whether this is the actual bony reason you perceive an external facial asymmetry. Ideally a 3D CT scan would be needed to confirm the diagnosis before one should do the surgery. The differences in the two sides of the face at the posterior zygomatic arch area will be clearly revealed by such a scan.

Dr. Barry Eppley

Indianapolis, Indiana