Q: I want to thin out my face and am thinking of having a facelift to initially tighten my skin and then my cheekbones (zygomas) cut and narrowed. The reason I am considering zygomatic reduction and face lift is to first “trim” excess skin for maximum tightening of the jowls, nasolabial region, cheeks and neck. Then narrow my face with zygomatic reduction, perhaps including the arch and the zygomatic body itself. I was hoping to improve skin definition below zygomatic arch and angularity of the jaw first, than schedule second surgery afterwards. Do you think it is a good plan for my case? Thank you kindly.
A: While I don’t have the advantage of looking at your facial pictures, I think your plan is fundamentally fine but it is planned in reverse. You want to do any skeletal or underlying foundational surgery first. The reason being is that such surgery causes a fair amount of external swelling which will stretch any tightened skin, potentially reversing some of the effects of any skin tightening procedure. Maximum tightening of the jowls cheeks and neck (facelift) should, therefore, be done after the bone foundation has been treated.
When considering zygomatic reduction, it is important to know if it will produce much of effect. This can be assessed by locally at plain film x-rays, particularly a submental and/or a water’s view. These simple films give a visual assessment of how significant the curve is on the zygomatic arches. That will have to be ordered through a hospital or any free-standing x-ray facility where the appropriate equipment exists.
Dr. Barry Eppley