A Novel Technique for Reduction Malarplasty by Inward Displacement of Infractured Zygomatic Arch Without Fixation

Abstract

Reduction malarplasty is one of the most common esthetic surgical procedures performed in the Asian population. Traditional procedures have several complications, such as bone nonunion, malunion, cheek drooping, and damage to the infraorbital nerve and maxillary sinus. Therefore, a more straightforward and effective method of reducing the width of the midface is needed. In this study, we introduce an infracture technique using inward displacement of the zygomatic arch without fixation. A total of 680 patients received zygoma reduction using our method from 2012 to 2016 in the Department of Plastic Surgery, Minhang Shanghai Hospital. Radiologic and photographic documentation was completed preoperatively. The mean follow-up period was 24months. The preoperative and postoperative photographs were compared. All patients were satisfied with their results. The mean operation time was approximately 35minutes.The patients were discharged 5days after the surgical procedure, and the mean recovery time was 2weeks. The continuity of the outer cortex of the zygomatic complex and excellent bone union were observed in all patients 6months postoperatively. The malar prominence underwent relapse in 23 patients and was reset. The new method that we developed has been proved safe and effective. It has 3 advantages. First, cheek drooping is avoided, and the damage caused by periosteum dissection on the whole zygomaticomaxillary area is limited. Second, bony fixation is unnecessary; thus the risk of bone nonunion, malunion, and a step-off deformity caused by improper fixation or looseness is prevented. Third, the operation time and the recovery time are short.