Will My Right Cheekbone Reduction Bone Asymmetry Result In Any Long Term Problems?

Q: Dr. Eppley, I had cheekbone reduction surgery last week. Upon having my post op CT scan — I noticed my right cheekbone was slightly separated. My doctor said this will heal fine, but I’m still concerned because every time I open my mouth or touch my right cheek—I can feel my cheekbone moving slightly and making tiny cracking sounds. It’s also a little difficult to chew on my right side. I know I’m very early I’m my recovery process, but my main concerns are that this will cause asymmetries in addition to malunion requiring further corrective surgeries and longterm complications such as skin sagging. What are your thoughts based on your experiences, doctor? 

Thank you 

A: You had the classic oblique cut cheekbone reduction surgery with plate fixation at its most inferior part closest to the intraoral incision. While the left side is ideal the appearance on the right side is not uncommon. There is a slight rotation of the right cheekbone segment which can happen as the superior part of the bone is not accessible for direct plate fixation.

Everything you are feeling on the right side is not abnormal and the bone segment should go on to heal. (it will probably heal with a fibrous union rather than a bony union…which does not matter in a non-mandibular facial bone) The sensation of movement should pass in a few weeks. This slight osteotomy line should not cause any asymmetry.

The risk of soft tissue sagging has nothing to do with the osteotomy line as long as the bone is stabilized from falling inferiorly. Soft tissue cheek sagging often occurs because of the way the procedure has to be done. (stripping of the soft tissues off of the cheekbones) and then reducing the projection of the cheekbone)

Dr. Barry Eppley

Indianapolis, Indiana