The width of the middle third of the face is primarily determined by the height of the cheekbones and zygomatic arches. The prominence of the cheekbones relates to proportions with other facial features, such as the width of the mandible, the width of the temporal bones, and the development of the temporalis muscles.Additionally, the prominence of the zygomatic bone is influenced by the amount of subcutaneous fat. Individuals with minimal subcutaneous fat or who are noticeably thin may also appear to have relatively higher zygomatic bones and zygomatic arches.Therefore, the height of the zygomatic bone and zygomatic arch is a relative concept without clear boundaries or diagnostic criteria. Since distinct visual differences in zygomatic bone and arch size can be observed in daily life and clinical settings, high cheekbones can be further categorized into "true" high cheekbones and "false" high cheekbones.
If most observers perceive an individual's zygomatic body as enlarged, accompanied by a distinctly high zygomatic arch that detracts from aesthetic appeal, this may be diagnosed as "true" high cheekbones. This facial type is commonly observed in Guangdong Province and Guangxi Zhuang Autonomous Region within China.Individuals with prominent cheekbones often exhibit bilateral asymmetry, sometimes accompanied by asymmetrical mandibular development on both sides. However, this can be considered normal, resulting from developmental differences between the left and right sides rather than pathological causes.If one side of the zygomatic bone or zygomatic arch is excessively developed, causing significant bilateral asymmetry, one should be alert to pathological changes, such as the possibility of abnormal fibrous bone proliferation or other masses.
The primary goal of this procedure is to remove enlarged zygomatic bones or zygomatic arches. Preoperative diagnosis must first confirm whether zygomatic hypertrophy is a physiological norm or a pathological abnormality. If pathological bone proliferation or a tumor is present, further systematic and comprehensive examinations along with integrated surgical treatment are required.For patients dissatisfied with the benign morphology of isolated zygomatic bones or arches, partial resection of these structures may be considered. Preoperative assessment must determine the degree and extent of zygomatic hypertrophy, the prominence of the zygomatic arch, and accurately measure and project the range and volume of bone to be removed.
For genuinely enlarged zygomatic bones, surgical removal of the hypertrophic portions is the only definitive solution. However, zygomatic hypertrophy manifests in three distinct patterns: protrusion forward, lateral bulging, or prominence at the temporomandibular joint (TMJ) region. The first two patterns can be effectively corrected surgically, while the third presents greater surgical complexity.
Most people associate cheekbone reduction solely with bone grinding procedures, yet numerous bone-shaving techniques exist. Based on surgical principles, these can be categorized into grinding methods, shaving methods, or combined grinding-shaving approaches. Beyond narrowing the cheek width, the primary goal is enhancing visual impact—specifically, creating greater facial depth and dimension.
Editor's Note: The cheekbones and jawbone together form the facial skeletal framework. Cheekbone reduction is a "bone-altering" procedure. Therefore, individuals considering this surgery must approach it with caution, thoroughly research the relevant information, and seek out a responsible, reputable plastic surgery hospital and surgeon.