Q: Dr. Eppley, I have cheek asymmetry and wonder what type of cheek asymmetry surgery would fix it. My left hand side cheek is more bulged out than my right one. I also have a dimple on my right cheek and there is not one on my right cheek. In my pictures you can see what I mean by the differences in my cheeks.
A: I can see that your left cheek does indeed bulge out more than the right and there appears to also be some other soft tissue asymmetries as well. The question is whether this bulge is due to a bony prominence or the overlying soft tissue. (or even a combination of both) I suspect it is due to bone because it is over the cheek bone prominence. A bone reduction (shaving ) may be all that is needed improvement. A cheek dimple could be made at the same time of desired.
To verify that it is indeed bone, a 3D CT scan would answer that question unequivocally. Bulging of the cheek prominence often occurs because of the union of the zygomatic and maxillary bones which form the anterior cheek prominence. Often it can be bowed out due to how the facial bones developed.
Dr. Barry Eppley
Q: Dr. Eppley, I have a cheek bone bigger that the other… due to a malocclusion and a deviated jaw. I was wondering if my jaw is place in position I will still have a cheekbone bigger that the other… where is the incision made to reduce this zygomatic bone in my case. Thanks for your time.
A: Without looking at any pictures of your face and x-rays, I can not answer how your cheekbone would look if your jaw is repositioned. Most likely, however, it will not look better and may likely look worse as the jaw is moved more into a more centric midline facial position. There are numerous types of cheekbone osteotomies, depending on what type of cheek bone reduction is needed. With facial asymmetry, most likely the bigger asymmetric cheek needs to be moved in medially towards the facial midline. This type of cheek osteotomy would be done through an incision inside the mouth. (vertical medial cheek ostectomy)
Dr. Barry Eppley