Cheekbone Reduction Reversal

Q: Dr. Eppley, I am interested in cheekbone reduction reversal. I had my cheekbones reduced and am unhappy with the result. Is it possible to rebuild the cheekbones up with calvarial bone grafting on defected cheekbones or use a bone substitute such as hydroxyapatite? What is the best way? Thank you.

A: Cheekbone reduction reversal surgery can be done by one of two ways. Trie reversal consists of opening up the osteotomy cuts and bringing the cheekbones back out through an interpositional graft and plate fixation. The most common technique to reverse cheekbone reduction largely depends on the osteotomy pattern through the malar body. If it was a straight line cut (which would be the most common technique) the bone can be brought back out and a small natural bone graft placed like a calvarial bone graft as you have mentioned. This is the most ideal way as you’re then assured it will fully heal. The interpositional graft could also be a cadaveric bone graft or a synthetic bone graft like hydroxyapatite.

The other method of cheekbone reduction reversal is to leave the infractured cheekbones where they are and placed an implant on top of them. Such cheek implants are ideally made from the patient’s 3D CT scan.

Each cheekbone reduction reversal method has its advantages and disadvantages. A 3D CT scan should be obtained for preoperative evaluation to help in this decision process.

Dr. Barry Eppley
Indianapolis, Indiana