Cheekbone Reduction Healing and Soft Tissue Sagging
Q: Dr. Eppley, I am very appreciative of your insight, it is amazing to even get a glimpse into your wealth of knowledge of facial surgery.
Is there any particular reason why the potential negative effects of cheekbone reduction only become evident after 3-6 months? No medical education here, but why wouldn’t the sagging not be evident straight after the surgery is over, right after the tissues have been peeled off the face?
In regards to the sagging, apart from the wide dissection that is required for the cheekbone to be reached for osteotomy – Are there any patient characteristics that would contribute to potential sagging? (eg. thick/thin skin, facial flatness, etc.)
Thank you again for your time.
A: Healing after any facial bone surgery requites two stages, swelling/edema resolution (first stage which takes 6 to 8 weeks to fully resolve) and then tissue contraction. (second stage, what I call the shrink-wrap effect, which takes 3 to 6 months to fully occur)
As a result of the natural healing process around facial bone reduction sites, It takes that long because the swelling supports the tissue initially and masks whatever sagging may subsequently occur. When the second stage of healing occurs (soft tissue contraction and tightening around the bone) the position of the overlying soft tissue becomes revealed.
It is easy to see how the loss of bone support allows the cheek tissues to be contacted down in a lower position. What is a more interesting question is why it does not occur in every case of cheekbone reduction… which it does not. This undoubtably occurs because of the variations in each patient’s anatomy and differences in surgical technique.
Dr. Barry Eppley