Zygoma Reduction Results
Q: Dr. Eppley, I had zygoma reduction surgery over 1 year ago in Korea. The method was L osteotomy cut with posterior bone cut, and then push the bone forward with screws. This was all done through intraoral incision method because I did not want scars on the face.
Unfortunately, there has been signs of skin sagging since 4 months after surgery.
My eyebrows have lowered, I have deep forehead lines when I try to open my eyes very wide.The cheek sagging is very obvious from side view, even though I see positive bone contour change from the front view. I am only 25 years old.
I am all healed but the negative effects very much bothers me. Excess skin folds run vertically on my side cheek. It is very obvious when I smile or wear makeup. I don’t know what is the cause and want to fix it.
The doctor said during surgery because I am young, the skin should shrink to match my new bone shape. But why is there extra skin after 1 years?! I have attached photo.
Can intraoral incision method cause more sagging than intraoral and sideburn incision method?
What is the solution to my problem?
A: It is not rare that once cheek bone support has been reduced after zygoma reduction a soft tissue sag will appear. This may not develop for months after the surgery when all the swelling has subsided and the temporary support that it provides goes away. This is not really a biologic surprise as the trauma of the surgery to the tissues and the narrowing of the cheeks can allow for a downward drift of the soft tissues.
The corrective approach requires a soft tissue resuspension down through a combined endoscopic scalp and intraoral approach to allow for tissue mobilization and suture placement for suspension.
Dr. Barry Eppley