Q: Hello Dr. Eppley, I was considering zygomatic reduction surgery to narrow the sides of my face. I am also considering SMAS facelift or modified SMAS like MACS-Face Lift to be done later this year. Could facelift interfere with zygomatic arch reduction surgery? Could you give me a second opinion if either or both procedures will take care of heaviness and fullness of my face? Would I esthetically benefit from these procedures and achieve better symmetry and balance to my facial features??? I have attached some photographs for you to see what I am talking about. Thank you.
A: In reviewing your two frontal photographs, I can see that you have a broad facial width across the cheeks and jaw angles. This skeletal base helps create more of a square face configuration which makes a significant contribution to your ‘heavy-looking’ face. Part of that appearance also has to do with your thicker soft tissues such as your skin, fat layers and muscles.
In considering how to make your face appear slimmer, I can clearly say that no form of a facelift will help in that regard. You are too young to have any significant sagging of your facial tissues (your pictures show none) and what any type of facelift accomplishes is cleaning up the jawline and neck of sagging tissues. In someone with your facial anatomy you are likely to end up making your face look a little wider by some type of a facelift, not thinner. You can’t make your tissues look thinner by lifting or tightening them. In making that statement, I am at a disadvantage since I can not examine you and am looking at only one view of your face.
Will zygomatic arch reduction help your face look somewhat slimmer? Quite possibly, it is just a question of how much. One helpful piece of information would be a simple submental view x-ray which could show how significant the arc is in your zygomatic arches. The more arched it is the more likely it will make a visible difference. The combination of zygomatic arch reduction and buccal lipectomies could likely be helpful.
Dr. Barry Eppley