Cheek Sagging after Zygoma Reduction

Q: Dr. Eppley, I had a zygoma reduction in January of this year. I’m 22 years old but I had some soft tissue trade offs and it didn’t really achieve the look I was after. I actually saw some tissue sagging 3 weeks post-op, but I had hoped it was swelling. Unfortunately, even now, I can still see the slight sagging. The area above the nasolabial area has become fuller and bulkier, and ages me. I feel older and don’t feel beautiful. 

The body of the zygoma was reduced by 4mm and the back of the arch was cut via a pre-auricular incision. I feel as if my surgeon over-corrected the reduction. When I smile, my side cheekbone area looks flat and my masseter muscle area is bulky and protrudes. I would like to add more volume to the outer portion of the zygoma body so that it isn’t as flat and over-corrected.

As for the sagging, I don’t know what to do? Please can you help?

I’m only 22 and I feel a midface lift is too invasive at this age. But I also hate seeing my sagging cheeks in the mirror and don’t think I can live with this. Will implants be enough to resolve my sagging? How big do I have to make the implants to resolve the sagging? 

I read on your blog that with jaw implants, the soft tissue from the face is stretched out, rather than from the neck. Would the malar implants be able to flatten my surgery-induced nasolabial folds as it stretches the cheekbone prominence back outwards?

A: Thank you for your inquiry. Yours postoperative situation is a common one that I see and your question as to whether zygomatic augmentation will reverse your cheek sagging/nasolabial folds is a valid one and the only recourse to this problem other than a midface lift.

The simple answer is that if the zygomatic augmentation replicates the shape of the zygoma and zygomatic arch before the surgery, this will give it the best chance to have a cheek lifting effect.

Dr. Barry Eppley

Indianapolis, Indiana