Prevention of Complication and Management of Unfavorable Results in Reduction Malarplasty.

Yang, Jung Hak; Lee, Ji Hyuck; Yang, Doo Byung; Chung, Jae Young

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(4):465-470.
Published online July 1, 2008.

Prevention of Complication and Management of Unfavorable Results in Reduction Malarplasty.

Jung Hak Yang, Ji Hyuck Lee, Doo Byung Yang, Jae Young Chung

¹Department of Plastic and Reconstructive Surgery, Dongdaemoon Hospital Medical College of Ewha Womans University Dongdaemoon Hospital, Seoul, Korea. leejihyuck@nate.com
²Jelim Aesthetic Plastic Surgery Clinic, Seoul, Korea.

Abstract

PURPOSE
Reduction malarplasty is a popular aesthetic surgery for contouring wide and prominent zygoma. However a few patients complain postoperative results and want to revise the midfacial contour. We analyzed the etiology of unfavorable results and treated unsatisfied midfacial contours after reduction malarplasty. METHODS: Total 53 patients were performed secondary operation for correction of unfavorable results after primary reduction malarplasty from elsewhere. Midfacial contour was evaluated with plain films and three- dimensional computed tomography. Unfavorable midfacial contours were corrected by secondary malarplasty. Flaring of zygomatic arch was reduced with infracturing technique and prominent zygomatic body was reduced with shaving. Drooped or displaced zygoma complex has been suspended to higher position and fixed with interosseous wiring. As adjuvant procedure, autologous fat injection has been performed in the region of depressed zygomatic body region.
RESULTS
The etiology of unfavorable midfacial contour after reduction malarplasty was classified into 7 categories: undercorrection of zygomatic arch(n=8), undercorrection of zygomatic arch and undercorrection of zygomatic body(n=6), undercorrection of zygomatic arch and overcorrection of zygomatic body(n=28), overcorrection of zygomatic body(n=3), simple asymmetry(n=4), malunion(n=2) or nonunion(n=2). Slim and balanced malar contour was achieved with treatment. And most of the patients were satisfied with the results of the surgery.
CONCLUSION
To prevent the unfavorable results after reduction malarplasty, complete analysis of facial contour, choice of appropriate operation technique, precise osteotomy under direct vision, and security of zygoma position are important.

Keywords: Reduction malarplasty; Secondary malarplasty

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