Cheek Sagging after Zygoma Reduction
Q: Dr. Eppley, I’m three months post op from zygoma reduction, and I’m just planning some backup procedures in the case of facial sagging even though I am only 23.
I would greatly appreciate it if you could answer some of my queries.
My procedure involved a 4mm resection of the zygomatic body and an inward push of the zygoma bone unit from the sideburns.
1) My understanding was, the side tissues of the face (near the ear) would not sag but simply move inwards with the inward push of the zygomatic bone. However, I’m finding that my bottom half of my face, specifically the tissues underneath where the zygomatic arch area is, are bottom heavy. Could this be sagging or residual swelling as this area is a lot puffer than the actual reduced cheekbone area.
2) How does a cheek resuspension procedure from the temples work? I’ve tried researching this but I simply don’t understand how a little suture can pin up all the tissues higher to the face.
Would this be a permanent suture or can dissolving methods be used? Would there also be hair loss? Would having screws be a hindrance to resuspension?
A: At three months after zygoma reduction, the fullness that you are seeing in your lower face is likely cheek sagging. But like all facial bone surgery I would give it a full six months after surgery to be sure all the swelling has subsided and the tissues have maximally contracted back down.
There a variety of surgical strategies to deal with the cheek sagging from tissue resuspension to facial defatting. In cheek resuspension there are a multiple of ways to perform it of which the temporal approach is but one of them…and it is my least preferred method because ideally the lift of the tissues should be more vertical rather than oblique. The true vertical cheek resuspension are either a superior cranial lift (pull) technique or an intraoral endocrine push technique.
Dr. Barry Eppley