What Can be Done For Asymmetry After Cheek Bone Fracture Repair?

Q: Dr. Eppley, I had a zygomatic surgery four weeks ago. My right cheekbone was broken.  The swelling has not completely gone down yet, but I can not understand the asymmetry in my face. My question is when these swellings will go away completely?  I feel very anxious about if my cheekbones will  have good symmetry again. It seems like I still have a collapse in my cheek bone even though there still is swelling present.

A: There is no question that zygomatic fracture repair can be associated with a large amount of eye and cheek swelling, particularly if it required a combined intraoral and eyelid incisional approach. Less swelling occurs from a more simple intraoral reduction. Since I don’t know the classification and magnitude of your cheekbone fracture and how it was treated, I can not say with any certainty about when most of the swelling will subside. But six weeks is a good time period to judge the results even though it may take until three months for all swelling and tissue contraction to occur.

However if in the face of swelling a cheek bone fracture repair shows persistent asymmetry, it may well be that the fracture repair was inadequate or not stabilized ideally. If this is the case, it is still possible at six to twelve weeks after surgery to do a revisional fracture repair with an improved outcome. (secondary facial fracture repair) Very delayed zygomatic fracture repairs may require camouflage procedures such as a cheek implant and/or combined with an orbital floor implant.

Dr. Barry Eppley
Indianapolis, Indiana