Friday, November 8, 2013

Cheekbone Reduction

Protruding cheekbone in the middle of the face makes the face looks bigger and rough.

Self-diagnosis

  • The face is flat and wide. Middle of the face is especially wide.
  • The face gives rough impression.
  • When looking at in front, protruding cheekbone makes the face look uneven.
  • Only the cheekbone is seen when looking at from 45 degree of the side.
  • Under the cheekbone looks dented and shaded.




Differences between before & after photos



Cheekbone reduction can be divided into three types.

▼ First, prominence of the cheekbone creates bumpy and irregular facial contours but this condition can be improved and the width of the entire face can be reduced through cheekbone reduction. Severe prominence of the cheekbone tends to experience more dramatic results.






▼ The wide region below the eyes and around the cheeks from the front view can significantly improve. The facial line is reduced from the front view, giving a youthful image and a profile look.









Surgical principles

There are two different types of cheekbone.

 






1. body : This region refers to the frontal cheekbone and prominence of the frontal cheekbone makes the outer ends of the eye look prominent or wider than normal.
The frontal cheekbone can be shaved off, and bone removal is required to move the entire cheekbone inwards.

2. arch : This region refers to the rear part of the cheekbone, which makes the face look wide from the front view and very bumpy from the side view because the frontal region of the ear is protruding. This part of the arch is cut near the sideburn region and the frontal cheekbone is also excised, making the entire cheekbone and arch move inward.

In most cases, both the body of the cheekbone and its arch are prominent. Therefore, surgical procedures on both parts are performed simultaneously.

The main concept of cheekbone reduction surgery is to reduce the protrusion of the bone. In order to do so, the protruding region is shaved off. But in order to maximize the results, more bone mass may need to be removed even than the actual bone mass. In order to improve this surgical limitation, the actual shape of the zygoma must be retained while a three-dimensional shift takes place and reduces the bone protrusion.

Every individual has a different size and shape of cheekbone. The body of the cheekbone may protrude, or the arch may protrude, or both conditions may be combined. Likewise, surgical procedures must accurately meet individual conditions and needs by a high level of skills and know-how.

An intraoral incision is made for the cheekbone surgery and a small preauricular stab incision is made for the zygomatic arch surgery. The incision is very small and is made inside the sideburn. The incision line fades away over time.










 
Frontal cheekbone refers to the protrusion of the cheekbone from the front view. In order to move this region inward, either the upper jaw or the cheekbone is excised to reduce the thickness. But the cheekbone is not very thick and there is an empty space underneath, so shaving off the bone cannot reduce the protrusion significantly.

45° cheekboneIn this case, the curved area from the front to side of the zygoma is prominent. Aside from shaving this curved region, shifting the cheekbone inward can reduce the protrusion. Therefore, the cheekbone and the zygomatic arch must be cut first. After shifting it inward, the moved bone must be tightly fixed.

Side cheekbonethe zygomatic arch on the side is either severely bent or protruding. The cheekbone must be moved to reduce the curve, so the cheekbone and the zygomatic arch must be cut first. After shifting it inward, the moved bone must be tightly fixed.
In order for the hard cheekbone to make a three-dimensional shift and be positioned inward, the front and posterior region of the cheekbone must be excised. After shifting it inward, the moved bone must be tightly fixed. This procedure has taken into consideration both safety and effectiveness of the surgery. In most cases, patients’ cheekbone accompanies a wide range of conditions, which requires the surgeon to combine several surgical techniques to maximize the effects. The degree to which the cheekbone looks inward can adjust the amount shift to be made through excision.

It is most important to accurately analyze and diagnose the patient’s cheekbone and decide on the shape prior to the surgery. Just like how surgery on square jaw considers the shape and thickness of the mandible as well as muscles and skin, cheekbone reduction should also consider fat deposits in the cheeks, the thickness of skin on top of the shape and thickness of the cheekbone. Therefore, X-ray analysis and detailed examinations on the cheekbone prior to surgery are crucial in successfully shifting the three-dimensional structure of the cheekbone. Surgical plans must be carefully established to maximize the effects.

In addition, this surgical method improves the conventional weaknesses of cheekbone reduction including cheek drooping, flat-looking face, and wide face. While shifting the cheekbone that protrudes at the 45° angle, the surgeon must retain facial volume and create a small and slim face that has a profile look from any angle. Moreover, cheekbone reduction must give the patient a youthful image by softening the overall facial contour and reducing its size.
Surgical procedures
① General anesthesia is carried out.
② An intraoral incision is made and the cheekbone is excised to shift its position.
③ An excision of the zygomatic arch is performed through preauricular stab incision and the cheekbone is moved.
④ The amount of inward shift of the protruding cheekbone is decided prior to the surgery and the cheekbone is moved.
⑤ The moved bone is fixed.
⑥ The surgery is completed within one hour.




 









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