Extended reduction malarplasty for Asians with flat and wide face: Comparison with L-shaped osteotomy.

Abstract

Reduction malarplasty is effective in correcting prominent zygomatic body and arch in Asian populations, but periorbital zygomatic bony protrusion may not be sufficiently improved. In this study, we present the extended reduction malarplasty procedures to correct it simultaneously and compare the outcome with that of conventional L-shaped osteotomy. A retrospective review of consecutive patients who received reduction malarplasty between August 2021 and September 2023 at our hospital was conducted. Computed tomography images obtained before and after surgery were assessed to evaluate the facial skeletal changes, and to compare between the extended and conventional L-shaped malarplasty results. Twenty extended reduction malarplasty patients and 23 conventional reduction malarplasty patients were eligible for the study. Cephalometric analyses showed significant reduction in the zygomatic width in both groups, but the protrusion of the periorbital area was improved significantly greater in the extended reduction malarplasty group. In terms of facial angulation, the extended reduction malarplasty also provided more horizontal convexity in the periorbital area, whereas the angular change in the caudal part of zygoma was not significantly different. The extended reduction malarplasty enabled to reduce the protrusion of the periorbital area, as well as the prominent zygomatic body and arch, and provided more three-dimensionality and horizontal convexity with the midface contour. It is a viable option for harmonizing the facial profile for Asian patients with flat and wide face.