Three-Dimensional Approach to Zygoma Reduction: Review of 221 Patients Over 7 Years.

Abstract

Zygoma reduction is commonly performed in Asian patients because a broad face is considered stubborn in appearance and unattractive. Consequently, a number of different techniques have been developed for zygoma reduction, the majority of which involve simple manipulations. However, no consensus has been reached on the optimal method. In the present report, we introduce a new method involving ostectomy and fixation that uses a 3-dimensional approach to zygoma reduction. From 2007 to 2013, 221 Korean patients (39 men, 182 women) underwent zygoma reduction using this technique. The bone was accessed via an intraoral and preauricular incision and removed in the body area using a small L-shaped osteotome through bone cutting in the arch area. The zygoma was moved anteriorly, medially, and caudally, and then fixed with a miniplate and screws. All patients were followed up for over 6 months and asked whether they were satisfied with the results. Four patients (1.8%) required further reduction and underwent a reoperation, but all were eventually satisfied. Two patients (0.9%) experienced overcorrection with a sunken area around the zygoma, which was corrected with autologous fat grafting after 6 months. Two patients complained of sensory changes around the upper lip, which resolved within 6 months. Two patients experienced dizziness, temporomandibular joint pain, infection, and/or cheek drooping. This new surgical technique causes less frequent and less pronounced cheek drooping and requires less bone stepping, resulting in greater patient satisfaction.