Zygomatic Bone Shaving

This procedure is a small operation for reducing the prominent cheekbones; its range of bone reduction is limited to the section from the anterior zygomatic body (below the eye sockets) to the parts near the junction of the lateral zygomatic body and zygomatic arch. The main goal of this procedure is not reducing the face width but softening the facial contour in the 45° side view or improving the condition of the asymmetric cheeks. Usually, this procedure is not performed only for fixing a wide face, but as a procedure for assisting in zygomatic bone cutting or a fine adjustment for revision surgery. The process of this surgery is relative simple; surgeons only need to make a 1.5–2cm incision in the intraoral upper gum, detach the skin from the bone, and then, directly grind off the protruding part of the zygomatic bone. Because the whole procedure needs no bone cutting, bone fixation, and additional incision in front of the ears, postoperative recovery is very fast. Because the range of this procedure is limited to the section from the zygomatic body to the lateral one-third of the zygomatic arch, it only regionally improves the condition of cheek protrusion in the front and 45° side views. This surgery will not achieve any reduction in patients with a truly wide face.

Surgical conditions

Duration

0.5hr
  • Type of anesthesia: IV sedation or general anesthesia
  • Type of incision: Intraoral upper gum (1.5–2 cm)
  • Recovery: 3–5 days
  • Removal of stitches: N/A

General instructions

No food and water on the day of surgery

0hr
  • Force on the face or squeezing of the face should be avoided for 3 months postoperatively.
  • Physical friction or irritation on the grinded parts should be avoided to prevent hyperosteogeny or bone regrowth.

Ideal candidates

  • Those who have normal face widths but mild cheek protrusions in the 45° side view.
  • Those with fleshy cheeks in the front view.
  • Those whose cheeks are mildly asymmetrical or unequal (unilateral correction).
  • Those with asymmetrical cheeks due to prior cheekbone reduction.

Potential complications

  • Bone regrowth
  • Unobvious results

Surgical advantages

  1. The surgical trauma is small and recovery is fast.

  2. No risk of poor bone healing or skin loosening.

  3. No need for bone screw and plate fixation.

  4. No limitation on food and mouth movement after surgery.

  5. Allows fine adjustment of one side cheekbone.

Surgical drawbacks

  1. Only partially improves the degree of cheekbone protrusion; no obvious result on reducing the real face width.

  2. Will result in bone regrowth on the shaved part in the future.

  3. The result can be different depending on the individual thickness and angle of the zygomatic bone.

Possible procedures in conjunction