How Can I Fix My ZMC Fracture After A Prior Unsatisfactory ORIF?

Q: Dr. Eppley,Hi, I understand your practice specializes in custom facial implants. I have a cosmetic bony deformity from trauma and I would like to learn about your experience with the outcomes of those specific implants and complications, planning procedure, choice of material, etc. Thanks

A: Thank you for your inquiry and sending your 3D  CT scans. What you had is a classic ZMC fracture with downward and inward rotation. Unfortunately the ORIF surgery failed to adequately derotate the ZMC complex so there is undoubtably some flatness of cheek projection extending out onto the zygomatic arch. Your two options secondary reconstructive options at this postop time period is a ZMC osteotomy with replating into a better anatomic position or a camouflage technique overlay technique using a custom implant design. Each option as its advantages and disadvantages. The custom inmplant overlay technique oiffers a less invasive surgery with a more assured anatomic restoration. Custom implant designing works just as well in secondary facial trauma patients as it does in aesthetic facial surgery. From a design standpoint it is ‘easier’ than aesthetic facial enhancement use because there is a well defined target. (the opposite normal side)

Dr. Barry Eppley

Indianapolis, Indiana