Zygomatic Arch Reduction

Q: Dr. Eppley, I am interested in zygomatic arch reduction. I am asking this because I have a wide face due to my zygomatic arch flaring out heavily toward the back, giving a somewhat rounded appearance.

Specifically I would like to know a few things:

1) Is a moderate width reduction possible without cutting the anterior portion (which seems too invasive for me)? How much is possible with just a posterior osteotomy? 

2) Is the recovery difficult? I.e. heavy bruising, difficulty chewing, swelling? Would an out of town patient be able to travel home shortly after surgery? How long after the surgery can a person return to work?

3) Are the results subtle or is it possible to tell that the bone was cut, like depressions, protrustions of bone, etc? 

4) Can the skin be affected afterward, as in drooping? 

5) What is average cost for such a procedure? Ballpark range?

Thank your for your time Dr Eppley. I have been considering this for a while.

A: In answer to your posterior zygomatic arch osteotomy questions:

1) It is fair to say that a moderate width reduction is possible just by cutting and moving in the posterior arch. Although the definition of ‘moderate’ is open to interpretation. In some cases optimal reduction is aided by a mid-arch osteotomy as well.

2) Recovery is not difficult at all. You would be able to go home the following day and return to work within a week out less.

3) The results would be subtle and smooth. There are no obvious depressions or irregularities because the overlying soft tissues are very thick.

4) No skin drop will occur for the same reason as in #3.

5) I will have my assistant Camille pass along the cost of the surgery to you later today.

Dr. Barry Eppley

Indianapolis Indiana