Which Is Better For Cheekbone Reduction – Shaving or Osteotomies?

Q: Dr. Eppley, My question is what’s the outcome of the differences between shaving the zygoma and the radical surgical method of cheekbone reductions? How much on average is each one? Do you have a before and after results/pictures of the shaving method being used on patients? Lastly, how invasive or risky is the other one like does it require screws and plates to keep the fractured zygoma in place or can it all be shaved to the back ends of the arch?

A: For cheek reduction shaving the zygoma is almost always a bad idea as that strips of all the soft tissue attachments, denudes the bone surface and prevents any soft tissue reattachments….i.e., cheek ptosis will assuredly result. And I assume you are referring to the zygomatic major part of the cheekbone and not the arch where no surgical access is possible as any shaving attempt is limited to the front end of the cheek bone only. Only cheekbone osteotomies can reduce the width of the entire cheekbone length with less risk of soft tissue cheek ptosis.

Dr. Barry Eppley

World-Renowned Plastic Surgeon