Women with prominent cheekbones are often labeled as having a "husband-killing face." Addressing cheekbone height thus becomes a primary concern. Located at the critical anatomical point of the middle third of the face, the cheekbone plays a vital role in maintaining facial aesthetics. Its position determines the three-dimensional contour of the face.Excessively high, wide, or low zygomatic bones can disrupt the anatomical proportions between the midface and upper/lower facial regions, resulting in an unattractive appearance characterized by a gaunt, masculine profile. Zygomatic bone reduction surgery effectively addresses these concerns.
Plastic surgery clinics indicate that zygomatic bone reduction is generally suitable for patients with prominent anterior-lateral facial structures. The procedure typically employs an intraoral incision to dissect and expose the zygomatic bone beneath the periosteum. Specialized instruments are then used to chisel away and thin the pre-designed portion of the zygomatic bone for removal, thereby narrowing the facial outer contour and refining the facial profile.The greatest advantage of this procedure is its seamless, scar-free outcome, leaving no visible traces post-surgery.
So, what are the primary methods for zygomatic bone reduction surgery?
1.The procedure is performed under general anesthesia. An intraoral approach is taken, making a 4-5cm incision along the buccal gingival sulcus on the buccal side to reach the periosteum through the mucosa and submucosal tissue. After hemostasis, a periosteal elevator is used to dissect subperiosteally toward the orbital floor and lateral orbital margin. Care must be taken to avoid damaging the infraorbital nerve near the infraorbital foramen.Subsequently, dissection proceeds along the lateral aspect of the zygomatic bone toward the zygomatic arch to expose the inner half of the zygomatic arch.Mark an arc-shaped osteotomy line with methylene blue on the lateral orbital wall, extending 8 mm from the orbital margin inward and downward to the outer-lower border of the maxillary process of the zygomatic body. Perform osteotomy with a width of 10–15 mm. Use a micro saw or splitting drill to sever the zygomatic body along the osteotomy line, ensuring the osteotomy surface forms approximately a 45° angle with the bone surface.Remove the excised bone segment to facilitate tight union of the two fracture surfaces.
3. After zygomatic body resection, make a 5mm skin incision anterior to the temporal hairline. Using mosquito forceps, bluntly dissect deep to the zygomatic arch bone surface. Insert a small bone chisel into the incision and gently chisel through the distal zygomatic arch, ensuring the fracture ends remain stable.At this point, the entire zygomatic bone and arch are free. Drill holes in the zygomatic body, lateral orbital wall, and inferior orbital margin, then secure with fine steel wire ligation.
4. Use a burr to smooth any irregularities at the zygomatic body fracture site. Secure the zygomatic periosteum to the temporalis fascia at the superior zygomatic margin with one suture.This prevents mid-face sagging complications after zygomatic bone reduction. After thorough hemostasis, suture the submucosal tissue with 1-0 suture and the mucosa with 3-0 suture. Apply mild compression during bandaging, avoiding pressure on the distal zygomatic arch to prevent collapse.
Editor's Note: Precisely because zygomatic bone reduction is technically demanding, it places relatively high demands on both the hospital and the surgeon. Patients seeking this procedure should exercise greater diligence in selecting their medical institution.