Should I Have Cheekbone Reduction Surgery?

Q: Dr. Eppley, I have a wide zygoma arch, and I’ve considering a cheekbone reduction for some time. But I’ve not read review of a single person anywhere who was happy with it. In fact I ran into many people who warn against the cheekbone reduction surgery as it causes droopy eyes and sagging skin. People end up getting face lifts and implants after it. I am attaching an image that will give you an idea of what I look like, however the result of the girl after the surgery doesn’t look great, I’m not sure for what reason. It looks bit extreme. I want to reduce just the width at the back, dont want to reduce the prominence of the cheekbone. I hope you’ll be able to provide me some insight, I have read so much on forums and all and can’t seem to understand as to why the result of this surgery are almost never satisfactory. Both my temples and jaw look concave because of my wide zygoma arch. Will the skin be saggy and eyes droopy due to lack of support and overall lack of definition even if I seek to reduce only 4mm or less at back of the cheekbone (only the arch)? 

Having done some surgeries already in the past I don’t want to take up a huge risk again, kindly refer to the pic attached and let me know if it will be worth it or not. I appreciate your help, thank you so much.

A: I certainly can not tell you whether you should or should not do cheekbone reduction surgery. All I can do is provide you with my experience with the procedure.

1) It is not my experience that the vast majority of cheekbone reduction surgery patients are unhappy or require secomdary management surgery. There are many satisfied patients from cheekbone reduction surgery but they less frequently are the ones most vocal on the internet. But like all aesthetic surgeries there are risks and tradeoffs. The risks are cheek asymmetries and over/under correction. The tradeoffs are potential soft tissue sagging, often of a relatively minor degree since most patients who undergo the surgery are young with better quality tissues.

2) There are many technical variations of cheekbone reduction surgery but the most important of them is the amount of inward bony movement that is done. It can be from 1mm to 10mms. The amount of inward movement is going to affect the risk of soft tissue sagging…the more inward movement the more likely some soft tissue sag will appear after surgery. Many times this operation is done maximally (in a cookie cutter fashion) and those are the patients most likely to experience postop soft tissue sag. The reality of these statements is that the patient has to make an informed choice before surgety….how aggressive does one want the cheekbone reduction to be vs what risk is one willing to take in altering one’s natural facial bone structure onto which the soft tissues are made to be. For some patients it is often better to compromise…accept some but perhaps not ideal reduction to mitigate the postoperative risks.

3) In aesthetic surgery there is always a completely assured way to avoid the risks…don’t do the surgery. After all this is purely elective and your life will continue onward without doing the surgery. As a general observation patients that have deep seated fears about surgical risks are not good candidates for surgery.

Dr. Barry Eppley

Indianapolis, Indiana