Reversing Facial Sagging After Failed Cheekbone Reduction Surgery

Описание: Prof. Lee Eui-Ryong, Oral & Maxillofacial Surgeon at Chung-Ang University Hospital, presents a detailed case of zygomatic non-union reconstruction with significant improvement in facial sagging.

[Case Summary]
A 27-year-old female patient underwent bilateral zygomatic reduction and genioplasty in October 2023. Postoperative plate fractures led to bilateral zygomatic non-union detected by CT in 2024. After a period of observation, CT in 2025 revealed progressive widening of the bony gap — surgery was then decided upon.

[Chief Complaints]
✔ Bilateral zygoma gap enlargement (up to 11.35 mm)
✔ Clicking/crepitus and discomfort while chewing
✔ Severe facial sagging from inferior displacement of the zygoma
✔ Double-curvature deformity (step-off) of the facial contour

[Surgical Plan & Technique]
• Superior repositioning of the non-united zygoma to promote bony union
• Iliac bone grafting to fill the bony defect at the osteotomy site
• 4-hole plate fixation (vs. standard 3-hole) for stronger stabilization
• Slight lateral expansion of the zygoma to restore volume
• Custom-fit plate NOT used — zygoma instability precluded use of surgical guide; intraoperative visual assessment was performed instead

[Outcomes]
✅ Complete elimination of bilateral zygoma gaps; solid superior union achieved
✅ Soft tissue of the cheek lifted superiorly, dramatically improving sagging
✅ Smooth single-arc facial contour restored (step-off deformity resolved)
✅ Enhanced zygomatic projection contributing to a more volumetric facial appearance

[Dr. Lee's Message]
"Zygoma reduction is soul-crushing surgery. If aging is like flipping an egg, intentionally reducing your cheekbones may accelerate that aging process. Please think more carefully before this surgery than any other procedure."

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