Zygomatic Arch Implant

Q: Dr. Eppley, I am seeking a zygomatic arch implant. I am 25 years old woman and three years ago I had my right arch of my cheek broken (zygomatic arch). After three weeks it was placed back into it’s ‘right’ position. Fortunately the scar is on my ear, but I have a little asymmetry which bothers me. I wish to have both sides of my cheek bones symmetric again. The damaged side of my face is flatter than the other side. I read on your website and in a lot of your comments in Real Self, that you are able to carve unique implants,that fit to the zygomatic arch and that might can solve my problem. Would you please send me how this surgery goes step by step and what results can we get from it? The surgeon, who placed back my zygomatic arch, suggested to rasp the healthy side. What do you suggest for me?

A: The concept of altering a normal side to match an abnormal side speaks for itself…that is not the thing to do. The correct approach is to build out the flatter part of the zygomatic arch and that can be done most easily and effectively by making a zygomatic arch implant to augment the inwardly displaced portion of the bone. That is usually done from inside the mouth and the implant come from several different methods. A preformed nasal implant can be used since it is straight and curvilinear and is designed to fit on a straight linear surface, an implant can be hand carved out of a ePTFE block based on intraoperatve measurements or a custom zygomatic arch implant can be made from a 3D CT scan.

Regardless of the implant used, the surgery remains the same.

For further assessment I would need to see pictures of your face from the side with you having drawn the outline of the depressed area.

Dr. Barry Eppley

Indianapolis, Indiana