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Reduction malarplasty by bidirectional wedge ostectomy or two percutaneous osteotomies according to zygoma protrusion type

 Wooyeol Baek  ;  Taeyong Woo  ;  Young Seok Kim  ;  In Sik Yun  ;  Jimyung Kim  ;  Se Woon Choi  ;  Tai Suk Roh  ;  Dae Hyun Lew 
 Journal of Cranio-maxillo-facial Surgery, Vol.44(10) : 1662-1669, 2016 
Journal Title
 Journal of Cranio-maxillo-facial Surgery 
Issue Date
BACKGROUND: Reduction malarplasty to correct prominent malar complex is popular in Asians. Despite the popularity of reduction malarplasty, most of the surgical methods applied are not selected according to the degree of zygoma protrusion. In this study, we analyzed the effectiveness of two different surgical procedures to clarify their appropriateness for each zygoma type. METHODS: One of the procedures used was the ""bidirectional wedge ostectomy,"" in which a bidirectional wedge-shaped bone fragment was removed from the zygomatic body via oral incision and oblique complete osteotomy of the zygomatic arch via sideburn incision. Another was the ""quick osteotomy,"" a greenstick osteotomy of the zygomatic body and complete osteotomy of the zygomatic arch via two skin incisions. We classified zygoma protrusion into two categories: only zygomatic arch protrusion (group 1) and zygomatic body and arch protrusion (group 2). RESULTS: The cross-sectional area of the most prominent malar region decreased by 9.4 ± 2.5 mm laterally (zygion-to-zygion) and by 2.9 ± 0.8 mm obliquely (average of center-to-right and left maxillozygion) after the ostectomy. However, in patients who underwent the osteotomy, while the cross-sectional area decreased by 10.9 ± 2.7 mm laterally, it did not decrease obliquely. Thirty patients (73.2%) in group 1 underwent the osteotomy, and the remaining eleven (26.8%) underwent the ostectomy. In group 2, 83% (n = 39) underwent the ostectomy. CONCLUSION: We were able to find the more appropriate procedure for each zygoma protrusion type through outcome analysis. With these results, we suggest that if each procedure is performed according to this classification, more favorable esthetic results of zygoma reduction can be achieved.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
김영석(Kim, Young Seok) ORCID logo https://orcid.org/0000-0002-0981-2107
노태석(Roh, Tai Suk) ORCID logo https://orcid.org/0000-0001-8681-159X
백우열(Baek, Wooyeol) ORCID logo https://orcid.org/0000-0002-6638-4110
우태용(Woo, Tae Yong)
유대현(Lew, Dae Hyun)
윤인식(Yun, In Sik) ORCID logo https://orcid.org/0000-0003-1103-7047
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