What Can Be Done For Cheek Sagging After Cheek Bone Reduction?

Q: Dr. Eppley, I have a question about cheek bone reduction. I hope you can help me because I am very afraid. I had a zygoma reduction with the L-osteotomy. Now my cheeks are sagging. I can see it because of the swelling look around my mouth. Now my surgeon told me that he will do a midface lift and Medpor implants. Will that help or not? I am afraid because I read on some pages that it is very difficult to fix this problem. Is that right? Please help me, I don’t know what to do.

A: One of the well known risks of cheek bone reduction is loss of soft tissue support or cheek soft tissue sagging. Since the cheek bones act as attachments and support for the midface tissues, it is no surprise that in some cases with some cheek bone techniques that the cheek tissues may sag afterwards. It is not a universal complication of every cheek bone reduction but it definitely can occur. It is for this reason that I like to perform cheek tissue suspension at the same time as the cheek bone reduction.

Now that you have it, and I presume you are at least 3 or 6 months from the procedure, the treatment would be the reverse of what caused the problem. At the least the cheek soft tissues need to be elevated and this could be done through a combination temporal and intraoral suspension approach. While adding bony projection with a cheek implant can be an adjunctive procedure to a cheeklift, it seems counterproductive to add back cheek prominences when you went through the original operation to get rid of them.

Dr. Barry Eppley

Indianapolis, Indiana