Reduction malarplasty using a zygomatic arch-lifting technique

Hwang, Chang Heon; Lee, Myung Chul

doi:10.1016/j.bjps.2016.03.004

Cited by 16 publications

(7 citation statements)

References 21 publications

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“…Once apparent soft tissue change occurs in the middle face after operation, it should be improved through relevant treatment. 9,19 Limitation Data measurement by CT lacks high precision and this can represent a limitation to the study. Further studies using magnetic resonance imaging may improve the accuracy of soft tissue measurement.…”

Section: Discussionmentioning

confidence: 99%

Midfacial Soft Tissue Changes After Reduction Malarplasty: A Computed Tomographic Study

Gao

Wei

Yuan

et al. 2021

Journal of Craniofacial Surgery

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Background:The reduction malarplasty has become one of the most popular esthetic surgeries among Asian women to improve facial contour. However, it is still controversial whether midfacial soft tissue changes after surgery, and more studies are needed. Methods: This retrospective observational study reviewed 30 patients who underwent L-shaped reduction malarplasty during January 2018 and August 2019. The preoperative and postoperative soft tissue thickness and the angle of nasolabial fold of the midfacial were assessed using photographs, threedimensional skull computerized tomography images, and the Wrinkle Severity Rating Scale. Results: The postoperative average level of nasolabial fold angle was lower than that observed in preoperative conditions, with the difference being statistically significant (t ¼ -10.262, P < 0.001). The postoperative fifth and sixth layers of soft tissue in the midface were significantly higher than those observed in preoperative tissues. Conclusions: Although L-shaped reduction malarplasty has evident effects on soft tissue changes of middle face, they are within acceptable ranges and do not affect patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Midfacial Soft Tissue Changes After Reduction Malarplasty: A Computed Tomographic Study

Gao

Wei

Yuan

et al. 2021

Journal of Craniofacial Surgery

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“…The optimal RM procedure should fulfil the following goals: midfacial width reduction, flattening of the zygomatic prominence, preservation of the natural malar curvature, nonvisible scar, and zygomatic complex sustained height as proposed by Nakanishi et al [ 10 ]. Of equal importance is maintaining intimate bone-to-bone contact on the zygomatic body’s osteotomy line and zygomatic complex (body and arch) fixation without bony dehiscence [ 19 ]. The fundamental problem of LORM is the instability due to poor fixation, which is exaggerated by powerful masseteric inferior pulling action [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Of equal importance is maintaining intimate bone-to-bone contact on the zygomatic body’s osteotomy line and zygomatic complex (body and arch) fixation without bony dehiscence [ 19 ]. The fundamental problem of LORM is the instability due to poor fixation, which is exaggerated by powerful masseteric inferior pulling action [ 19 , 20 ]. Not surprisingly, the literature revealed that postoperative zygomatic complex mobility is conductive to complications such as malunion or nonunion with resultant unfavourable outcomes such as sagging of the cheek, facial asymmetry, malar depression, and restricted jaw movement [ 16 , 21 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to studies by Baek et al [ 16 , 23 , 24 ] and Lee and Lee [ 22 ], the intraoral approach does not allow fixation of the lateral orbital rim side, it cannot withstand the strong action of the masseter muscle, which may cause the unfavourable outcomes mentioned above. On the other hand, Hwang et al [ 19 ] and Wang et al [ 21 ] explained the effect of zygomatic arch fixation method on the stability of RM outcomes despite the fixation methods used on ZB region.…”

Section: Introductionmentioning

confidence: 99%

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Stability of different fixation methods after reduction malarplasty under average and maximum masticatory forces: a finite element analysis

et al. 2023

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Background Although titanium plates/screws are effective fixation methods (FM) after L-shaped osteotomy reduction malarplasty (LORM), the ideal FM remains controversial. This first finite element analysis (FEA) aimed to study the effect of various zygomatic body/zygomatic arch FM combinations and their placement vectors on the zygoma complex stability after virtual LORM under the effect of both average (150 N/mm2) and maximum (750 N/mm2) forces and three-dimensional (3D) mapping of stress and strain parameters distribution over the zygomatic bone, fixation methods, and total model. Results The fixation methods about the short-arm of the L-shaped osteotomy showed lower stress, strain, and displacement values than those across the long-arm osteotomy site. Combined with any zygomatic arch fixation methods (ZAFm), the two bicortical screws group (2LS) on the zygomatic body osteotomy site resulted in smaller displacements and the lowest zygoma bone stress and displacement when combined with Mortice–Tenon structure (MT) as zygomatic arch fixation method. Applied forces caused statistically significant differences in zygomatic bone stress (P < 0.001 and P = 0.001) and displacement (P = 0.001 and P = 0.002). Conclusion All FMs both on the zygomatic body and zygomatic arch provide adequate zygomatic complex stability after LORM. The 2LS group showed better resistance than rectangular plate (RP) and square plate (SP) with lower stress concentrations. The L-shaped plate with short-wing on the maxilla (LPwM) is more stable than having the short-wing on the zygoma bone (LPwZ). Future prospective clinical studies are required to validate the current findings.

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“…As a result, reduction malarplasty, which is a surgical method for facial contouring, to change the outline of the middle face is one of the most common plastic surgeries among Asian women. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

Novel treatment of revision malarplasty with piezosurgery

et al. 2020

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Background: Reduction malarplasty is a routine clinical procedure among Asian women, but the traditional surgical methods are still associated with serious complications, such as nonunion of the osteotomy sites. Revisional surgery to correct such complications is common, but poor bone healing in the osteotomy area presents a challenge to plastic surgeons. In this report, the authors present a new technique for revision malarplasty that uses the piezosurgery (piezoelectric bone surgery) approach. Patient and diagnosis: A 30-year-old female patient underwent reduction malarplasty with titanium plate fixation in the zygomatic region at another hospital 4 years ago, but the root of the zygomatic arch was not fixed. The patient was diagnosed with bone nonunion, facial asymmetry, and soft tissue sagging on the right side of the face after malarplasty. Intervention: We used piezosurgery to truncate the displaced healed broken end of the zygomatic bone according to the original osteotomy line. Following this, the malar was re-fixed with micro-titanium mesh, and the zygomatic arch was fixed with a titanium plate. Outcome: The patient was followed up for 11 months after the revision procedure. Her facial appearance was satisfactory, and no complications were observed on computed tomography images. Lessons: This report presents a novel therapeutic option for surgical revision of failed malarplasty. Piezosurgery can help overcome the limitations of traditional surgical methods by reducing bone resorption, preventing resorption of the bone in revision malarplasty, modifying the degree of inward and upward movement of the zygomatic bone by facilitating adjustment of the position of the drill hole in the cortex of the bone stump for stable fixation. Hence piezosurgery can be a simple, accurate, and non-invasive osteotomy method for revision malarplasty.

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Reduction malarplasty using a zygomatic arch-lifting technique

Cited by 16 publications

References 21 publications

Midfacial Soft Tissue Changes After Reduction Malarplasty: A Computed Tomographic Study

Midfacial Soft Tissue Changes After Reduction Malarplasty: A Computed Tomographic Study

Stability of different fixation methods after reduction malarplasty under average and maximum masticatory forces: a finite element analysis

Novel treatment of revision malarplasty with piezosurgery

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