Zygoma Reduction – The Risks And Benefits

Although zygoma reduction is perceived as a fairly new and radical surgery, methods of reducing the cheekbone arch have been perfected for over 20 years.

The cheekbone area has a significant impact on overall facial proportions together with the way the soft tissue drapes over the facial skeleton.

Although zygoma reduction is perceived as a fairly new and radical surgery, methods of reducing the cheekbone arch were first developed in the early 1980s. Korean surgeons pay particular attention to this part of the cheek, which notably concerns the bony prominence at the side of the face, directly in front of the ears.

One of the most off putting aspects of zygoma reduction surgery is its seemingly invasive nature. Recovery can be difficult, with midfacial swelling lasting up to 6 weeks or more. The surgery can be performed at the same time as double jaw surgery, or via a coronal incision extending all the way across the top of the skull. However, zygoma reduction Korea-style does not necessarily require large incisions.

Where is the zygomatic arch?

zygoma reduction before after

The zygomatic arch is the area right beneath the outer rim of the eye socket, extending sideways in front of the ear.

Risks of zygoma reduction

The zygomatic bone forms part of the face’s supporting bone structure. Reducing the facial skeleton means that there will be a degree of excess soft tissue left over, which may be small or large depending on the amount of bony reduction. If the patient has an overabundance of upper cheek fat and small cheekbones, then they will not be a good candidate for zygoma reduction due to the fact that their tissue will drop down, causing sagging skin.

Another risk is the cheek muscle becoming detached from the bone. This usually happens in cases where the zygomatic bone has been sanded down or burred with a special instrument. Such an approach requires the surgeon to deglove the bone from the muscle and skin before accessing the zygoma. If this approach is taken, the soft tissues need to be resuspended afterwards.

In rare cases, the zygoma may be accidentally fractured in the wrong place, leaving a splinter of bone that is visible underneath the skin. In such instances, bone paste can be used to cover the fractured bone spur.

Reducing the wrong part of the cheek is another risk of zygoma reduction. The surgeon must be cautious to assess whether zygomatic arch reduction would be best combined with augmentation of the central part of the cheekbones – the malar eminences. In some people, this area may appear quite retrusive (under projected), particularly if they have an underbite. Concurrently, the zygoma may appear to be too large. Enhancing the projection of the malar area at the same time could therefore help take up any redundant soft tissue caused by the zygomatic reduction surgery.

Infection from titanium screws is a rare risk of the surgery. If you opt for burring or sanding of the zygoma, then you will not require titanium screws.

Asymmetry is a risk of zygoma reduction. This can be avoided if your surgeon uses modern CT scan technology, allowing very precise measurements of your skull to be taken so as to accurately assess the amount in millimetres that each zygoma bone needs to be reduced by. The skill of the surgeon is very important, but if you are left with asymmetry then there are less invasive options to improve it later on, such as fillers or fat grafting.

Finally, overcorrection is a possibility. This is when the cheekbone is reduced too much, requiring future insertion of implants or zygomatic arch augmentation to correct.