Hydroxyapatite Cement Zygomatic Augmentation
Q: Dr. Eppley, Around half a year ago, I underwent cosmetic malar bone reduction to correct some facial asymmetry. I’ve always been conscious of the asymmetry of my cheekbones and always had my hair down to cover their protrusion.
The surgery did reduce the cheekbones. When my face is in a still, non-smiling position, there is still some very very minor asymmetry but only in my eyes.I understand that perfect symmetry can’t be achieved.
However, though the surgery solved one problem, it gave rise to another.Though my surgeon corrected the asymmetry to the best of his abilities, I’m now worried about my right side. My right side initially has less of a protrusion prior to the left but my surgeon reduced the zygomatic bone by the same amount as the left.
I’m finding that on the right side of my face (right in front of the ear, right underneath the zygomatic arch bone, not the anterior bone) there is a very slight depressed area of tissue or bone (?) when I smile. I am annoyed because I spent money to fix my asymmetry problem and now I have another from trying to fix it.
I’m finding that when I smile, my bottom side on the right side juts out right underneath the depressed area. The left side doesn’t seem to have this problem and fully curves out when I smile. It makes me look lop sided when I smile and I STILL have to use hair to cover my insecurities.
What can be done to fix this? I know that it’s stupid to fix something on your face when it’s in a smiling position but I just hate that my face has become lop sided after I tried to fix lopsidedness from another area. I would like a more permanent solution if there is one.
Can hydroxyapatite cement be used to build out this area?
A: Certainly the depressed area could be augmented as it probably represents the infractured portion of the posterior zygomatic arch. There are a variety of materials that would be used to achieve this augmentation of which hydroxyapatite cement would be one of them.
Dr. Barry Eppley