Zygoma Reduction After Surgery Concerns

Q: Dr. Eppley, I am roughly 8 weeks post op from zygoma reduction, buccal fat reduction, and genioplasty to reduce the width of my chin. I really hope you can help me out with some questions because my original surgeon is not being very helpful and is now unresponsive.

Prior to the surgeries, one of my cheekbones protruded more than the other, causing some facial asymmetry. But my doctor removed a wedge of bone of the same length from both sides of my face. Is it normal to reduce the left and right zygoma by the same length when the original cheekbones are obviously asymmetrical? Would this not just keep the asymmetry and push them in, so that it’s pushed in and asymmetric. Why wouldn’t different widths have been taken out.

What I’ve also noticed is that the side with the originally less protruded zygoma, is some asymmetric cheek fullness as well. When I smile it becomes very obvious. There is this deeply sunken in part right underneath the arch area of the zygoma and right in front of ear tragus and on the mandible area. Would this be from the zygoma reduction or the buccal fat pad removal?

I understand that there is definitely some residual swelling left but this has been extremely distressing. If this sunken in area persists, what should I do?

I’m not sure about whether I should fat graft the area, but I’m also worried about spending money on a procedure that can’t guarantee fat retention. Or is there some sort of permanent injectable that can be used to build out the area. I don’t need a specific shape like a cheek implant, but just like a slight pushing out of the area.

A: In answer to your after surgery zygoma reduction questions:

1) The specifics of your surgery are only known to your surgeon. That is his responsibility to explain what was done and why.

2) It will take a full is months to see the final result of your reshaped face and that should be taken into consideration when considering any revision.

3) Buccal fat removal will not cause any indentations back by the ear or underneath the zygomatic arch, that is caused by the bone reduction.

3) Fat injections, while not always predictable, are the safest soft tissue volumizing filler to use.

Dr. Barry Eppley

Indianapolis, Indiana