Cheekbone Reduction and Soft Tissue Sagging

Q: Dr. Eppley, My face is quite wide and I am interested in cheekbone reduction. I’ve done quite a bit of research online about the different techniques that exist and have read some studies online so I know exactly what I am getting myself into.

I’ve read that the L osteotomy cheekbone reduction is quite commonly used and involves taking out a wedge of bone up to 8mm wide. I would like to get my head wrapped around one thing however.

When the cheekbones are reduced, logically there is now excess soft tissue whether it’s from reducing 3mm of bone or 8mm. Where do these excess tissues go as I’ve read some people sag, some people don’t.

Do the soft tissues shrink wrap in size and how long does this process take?

Or does the soft tissue just fall downwards and create a sag that is only noticeable in some people?

A: It is important to remember that when any facial bone structure is reduced, there may be soft tissue consequences for the loss of bone support. This is particularly relevant in the chin, jaw angles and cheeks of the face. So your question about whether soft tissue sagging could occur with cbeekbone is relevant. There are numerous factors which can affect whether it occurs or not such as the amount of bone removed, the extent of the subperiosteal tissue dissection, whether soft tissue resuspension is attempted and the patient’s anatomy. It does not always occur and, even if it does, it may or may not be of aesthetic concern to the patient.

Dr. Barry Eppley

Indianapolis, Indiana