Cheek Sag after Cheekbone Fracture Repair

Q: Dr. Eppley,  I was involved in a car accident a while ago that required my chee bone to be repaired. The surgeon that operated on me performed the surgery was a plastic surgeon, rather than a craniofacial or maxillofacial surgeon. My cheekbone fracture was secured together with plates and screws and was performed entirely through an incision in my upper gum.

It’s been a while since the surgery and I swear in my eyes, the cheek on the operated side looks different. My friends don’t seem to notice but I swear it looks slightly off. I think they just never notice because I’m always moving and they never just look at my face straight on. 

I feel as if the cheek flesh/apple cheek underneath my eye has shifted downwards. I can tell because in my photos prior to the surgery, when I smiled widely, the bump of the cheek (the fleshy apple cheek bump) was a lot closer to my eye. Now it’s more in the middle of my face, noticeably lower than it was before. I don’t think any resuspension was done after the bone repair.

Since I am young a midface lift on one half of my face is just out of the question. Is it possible to relift the soft tissues and somehow have them heal and stick to the cheekbone higher?

Ideally I wouldn’t like any scars on my face, but hidden oral and scalp incisions would be alright with me. Also, are there any absorbable solutions, as I’m a little bit iffy in leaving permanent devices in my face.

A: By your description your cheek sag may be exclusively soft tissue or it ma be combined with some residual bony displacement as well. I would need to see pictures of your face to help make that determination. But a cheek lift can be done through a lower eyelid, temporal scalp incision or even an intraoral approach could be used.

Dr. Barry Eppley

Indianapolis, Indiana