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Zygomatic Arch Reduction

This procedure is mainly used to improve the condition of a wide face (“pancake face correction”) caused by zygomatic arch protrusion laterally, but it cannot obviously change the zygomatic body. It is often performed on patients with a mild or moderate wide face or those who want to retain the original angle of the zygomatic bone but only improve the bony protruding parts of the lateral cheekbone. This procedure has two incisions: one is in the intraoral upper gum (approximately 2 cm) and the other is behind the temporal hairline (approximately 1 cm). From these incisions, Dr. Chuang will detach the skin and bone first to create the appropriate surgical field and then will perform an “I” or “L” cutting procedure at the junction of the zygomatic bone and arch using a high-speed electric sawing machine. To prevent involving excess zygomatic body, the cutting line should be placed from the lateral one-fourth to one-third of the zygomatic bone; Dr. Chuang will also cut through the posterior part of the zygomatic arch in front of the ears to keep the whole zygomatic arch to be inwardly movable. After the anterior and posterior parts of the zygomatic arch are cut through, their entire lateral sections can be internally rotated and folded. In this manner, face width on the front side can be effectively reduced, but the regional cheekbone contour can still be retained. Finally, Dr. Chuang needs to fix the anterior and posterior cross-sections by titanium bone screws and plates. The characteristics of this surgery are as follows: cheekbone features can be maximally maintained (such as the line of 45° angle or zygomatic muscle) and only the posterolateral width of the zygomatic arch is reduced by 0.5–0.8 cm at either side. This procedure is suitable for patients whose faces are flat but become wide due to posterior zygomatic arch protrusion.

Surgical conditions

Duration

0.5hr
  • Type of anesthesia: General anesthesia
  • Type of incision: Intraoral upper gum (2 cm) and within the anterior auricular hairline (1 cm)
  • Recovery: 5–7 days
  • Removal of stitches: 7 days

General instructions

No food and water on the day of surgery

0hr
  • Only a soft or fluid diet should be consumed for 2 weeks postoperatively.
  • Extensive opening of mouth or consumption of very hard food and fruits should be avoided for 1 month postoperatively.
  • The face should be protected against any external impact or pressure for 3 months postoperatively.
  • It is better to wear a head compression garment to prevent skin loosening or drooping for 3 months postoperatively.

Ideal candidates

  • Those with flat cheekbones but wide faces.
  • Those with obviously splayed or protrusive zygomatic arches in the front view.
  • Those with depressed temples or lower cheeks due to cheekbone protrusion.
  • Those who only need to reduce facial width but want to preserve the facial contour in the 45° side view.
  • Those who are concerned about potential cheekbone sagging due to over-reduction.
  • Those with facial skin laxities who are unsuitable for extensive zygomatic bone reductions.

Potential complications

  • Cheek sagging
  • Bone screw loosening
  • Poor bone healing
  • Unobvious results

Surgical advantages

  1. Surgical trauma is relatively small and recovery is fast.

  2. Will retain facial stereo sense from the 45° side view and zygomatic muscles.

  3. Only reduces the lateral width of the face, so the surgical results are natural.

  4. Less likely to cause complications of cheek skin drooping due to excessive facial bone reduction.

Surgical drawbacks

  1. Overall degree of zygomatic bone reduction is limited (at most 0.5–0.8 cm on each side).

  2. Unsuitable for patients with a severe wide face due to too high or prominent cheekbones.

  3. Zygomatic arch and body need to be fixed together in the new alignment; the result is subjectively achieved by a doctor’s sense of beauty.

  4. The result of face slimming will not be quite obvious.

Before & After

These photographs represent typical results, but not everyone who undergoes plastic surgery will achieve the same.

Zygomatic Arch Reduction – Female

Zygomatic Arch Reduction – Male