Cheekbone Reduction Soft Tissue Sagging
Q: Dr. Eppley, I am exactly 3 months post-op from a cheekbone reduction. My cheekbones were reduced with an L shaped bone cut which removed 4mm of bone from each body of the zygoma.
I’m not very happy with my current results but I’m not sure whether I am in the right position to be judging yet. A lot of doctors I’ve consulted say that my results now are pretty much the final results with unnoticeable changes to occur in the next 3 to 6 more months. Others say that I will see noticeable difference between now and 6 months post-op. I’m not sure what to believe.
I’m only 22 and I had no wrinkles next to my nose prior to surgery. At 3 months, my cheeks look puffy and slight nasolabial wrinkles have appeared. I think that the excess soft tissue that was suspended outwards fell downwards as the 4mm of bone projection was removed. Nevertheless, it is not an acceptable tradeoff for me.
Is it too optimistic to hope that this completely resolves in the next 2 or 3 months? Could it possibly be due to residual swelling and may go away with further time and tissue contraction? My soft tissues I think are quite thick and I’m not sure if that made me more prone to soft tissue sagging.
Fillers for the rest of my adulthood is not an option for me and a cheeklift seems quite extreme. I have no jowling around the bottom area of my face, it’s just the nose wrinkles that are of concern to me. ‘m scared that my cheeks will look unnaturally pulled upwards and wide if they are pulled towards the temple.
If I were to get my pre-surgery CT scan and got custom implants to restore my original bone structure, would this lift the tissues back out and resolve my current issue of the nose wrinkles? I am still quite young and I don’t think my tissues are stretchy and loose. Is it possible to resolve this wrinkling issue with just implants?
A: In answer to your soft tissue changes after cheekbone reduction surgery, which I have heard many times, I can provide you with the following two specific guidances:
1) The only way to know whether the soft tissue effects you see now, at 3 months after surgery, are the final result or will improve is…time. Give it a full 9 to 12 months and you will have your definite answer. Any opinion about that issue short of this time period is just that,,,an opinion not a confirmed fact.
2) Whether custom designed cheek implants will completely correct these soft tissue changes caused by cheekbone reduction can not be accurately predicted beforehand. But partially or fully reversing the cause (loss of bone upper) wold be the most anatomically based approach to the problem.
Dr. Barry Eppley