Can My Old CheekBone Fracture Be Fixed?

Q: I have an old indented fracture of my left cheekbone. I fell several years ago on my face and was diagnosed with an ‘infracture of my zygoma’.  It didn’t seem to bad at the time but maybe the swelling made it look better than it was. Now that side of my cheek is flatter and asymmetric to the opposite cheek. Can it be repaired?

A: Zygomatic, or cheekbone fractures, are common facial injuries. When fractured, the cheekbone rotates downward and inward, causing loss of prominence of the cheek. While the swelling may camouflage the ultimate degree of cheek flattening, eventually an asymmetric cheek will result if not repaired as the swelling goes away and the overlying soft tissue contracts.

Secondary correction of the cheek flattening can be done by one of two approaches. A cheek implant can be placed through the mouth to build the depressed part of the cheek back out. With some many different styles and sizes of cheek implants available today, a lot of cheek reshaping can be done with an implant alone. The other more extensive alternative is to re-fracture the cheekbone and move it back into its original position. (cheek osteotomy) Generally, a cheek osteotomy is reserved for those cheek deformities where the amount of cheek flattening is severe, the position of the corner of the eye is pulled down, and/or there is numbness of the lip and nose from the infraorbital nerve being impinged from the bone displacement.

I suspect your cheek deformity is more modest, since it was not initially repaired, and an implant would be the simplest and less complicated treatment approach.

Dr. Barry Eppley

Indianapolis, Indiana