Can The Posterior Zygomatic Arch Be Further Reduced after Cheekbone Reduction Surgery?
Q: Dr. Eppley, A year ago I had zygomatic reduction in Korea. There was an incision in my sideburn and in my mouth, where they cut the bone and moved it in. I am happy with the reduction, but the part of my cheekbone that is posterior to the sideburn incision (toward the ear) still sticks out, since only the cheekbone anterior to the incision was moved in. Is there a way to reduce the bone behind the incision that is closer toward the ear?
A: That is not an infrequent ‘problem’ that is seen after cheekbone reduction osteotomies. It has to do with the projection of the remaining posterior zygomatic arch which sits behind the osteotomy. This can be reduced by an additional osteotomy further back along the arch or direct burring down of the projection right down to its temporal bone attachment.
Provided that the posterior zygomatic osteotomy was not plated, a useful technique I have found to be help for this aesthetic problem is a percutaneous osteotomy technique. By walking a small 2mm osteotome along the posterior zygomatic arch a series of bone cuts can be made to push the bone further in…without having to reopen the surgical incision.
Dr. Barry Eppley