Overview

Some Asians, particularly those of Mongolian, Northern Chinese, Korean, and Japanese descent, have high cheekbones (zygomas) and a distinct lower jaw (mandible) contour. These characteristics are unique to these Asian ethnic groups because their anthropometric features are often characterized by prominent zygomas and mandibular angles, which disrupt facial harmony and cause the face to appear overly flat, wide, and square.

Asians' perceptions of beauty have shifted dramatically over the years. Facial shape is the most important aspect of facial beauty, with an oval face being considered attractive and youthful. A smooth egg-shaped curve outlining the perimeter of the face, with a smooth transition from the forehead through the temples, around the outside of the cheeks, preauricular region, angle of the jaw, and jaw line through to the chin, with no indentations or projections in the line, characterizes an oval face. In recent years, there has been an increase in the demand for zygoma and mandibular prominence correction, particularly in countries such as Korea, Japan, Taiwan, and China, in order to achieve these aesthetic goals.

 

What is Zygomatic Reduction?

Cheekbone reductions involve reshaping the contours of a person's cheek to produce a more aesthetically pleasing result. The procedure specifically reduces the width between the peaks of the cheekbones, altering the proportions of the face to improve the patient's appearance. During the procedure, care must be taken to remove only enough bone to achieve the desired contours while avoiding damage to the infraorbital nerve, which supplies sensation to the sides of the face.

Cheekbone reduction surgery can help you achieve a more refined and feminine appearance. Cheekbones are one of the most prominent features in the center of the face, and as such, they play an important role in defining one's overall facial appearance. If the cheekbones are overly prominent, the face may appear larger than it is, giving the person a harsh, intense, or fierce appearance. The procedure of cheekbone reduction is used to reshape prominent cheekbones. Because Koreans have high cheekbones, Korean plastic surgeons have become internationally renowned for their expertise in cheekbone reduction.

Malar reduction or zygoma reduction are other terms for cheekbone reduction. The procedure is performed not to flatten or shave the cheekbone, but rather to reshape the cheekbone in such a way that it reduces facial width while also giving the face more three-dimensional depth, as opposed to the flat appearance of people with enlarged cheekbones.

A zygoma reduction is a cosmetic surgical procedure that reduces the size of the zygoma or cheekbones. It is a more advanced version of traditional jaw and chin procedures that generally involves fracturing, trimming, and rotating the cheekbone to remove or correct bone protrusions that create a strong or harsh appearance. The procedure is widely used in East Asian countries where zygoma is prevalent. Despite the fact that there are some surgical risks, it has a high satisfaction rating.

Cheekbone reduction surgery, also known as zygoma reduction surgery, is a cosmetic surgical procedure that reduces the width of the upper face, specifically the cheekbone, to make the face appear smaller, oval, and more feminine. This surgical procedure is frequently performed on patients who have a wide face as a result of large or prominent cheek bones.

 

Who is a good candidate for Zygomatic Reduction?

Patients with prominent front cheekbones, broad cheekbones, and a disproportionate or unbalanced facial structure benefit the most from cheekbone reduction. The surgery can remove or correct bone protrusions, making the facial line appear sleeker, slimmer, softer, and far more beautiful and appealing.

The following people are good candidates for cheekbone reduction:

• Those with wide faces but flat cheekbones.
• Those who have clearly splayed or protruding zygomatic arches in the front view.
• Those who have depressed temples or lower cheekbone protrusion.
• Those who only need to cut back
• facial width while retaining the facial contour in the 45° side view
• Those who are concerned about cheekbone sagging as a result of over-reduction.
• Patients with facial skin laxity who are not candidates for extensive zygomatic bone reductions.
• Those with a positive attitude, realistic expectations, and specific goals for improving their facial appearance.
• Those who are in good physical health and do not have any active or serious pre-existing medical conditions.

 

How is Zygomatic Reduction surgery is performed?

Patient preparation

You will meet with the surgeon to discuss your objectives and how best to achieve them.

• A discussion about the patients' expectations and desired outcome
• Blood tests or a medical examination for anesthesia and surgery fitness
• Medical conditions, drug allergies, and previous medical or surgical treatments are all evaluated.
• A physical examination includes a blood test and a chest X-ray. If the patient is over the age of 40, an ECG will be performed to determine the risk of a heart condition.
• Avoid taking certain medications or make changes to your current medications.
• For at least two weeks, discontinue all anti-inflammatory medications such as aspirin and ibuprofen. Avoid herbal supplements and vitamins, as they may cause more bleeding during and after surgery.
• Examination of the face and soft tissues 
• Radiological evaluation (CT scan of face)
• Preoperative evaluation for general anesthesia 
• Facial X-ray to analyze facial structure and determine the best technique
• Smoking and alcohol should be avoided for at least two weeks before surgery.

You can assess whether you have enlarged cheekbones by simply looking at your face in the mirror from different angles and under different lighting conditions. Your face is broad and flat, especially in the middle. When viewed from the front, prominent high cheekbones give your face an uneven appearance. When looking from 45 degrees to the side, only your cheekbones are visible. The area beneath your cheekbones appears dented and shaded.

Prior to deciding on malar reduction techniques, the patient will be required to undergo a facial X-ray in order to analyze the facial structure. The surgeon will also be able to determine whether the protruded cheeks are made up of muscles, bones, or excess fat in order to select the best procedure.

 

The procedure

Cheekbone reduction is a surgical procedure that requires a brief inpatient stay and is usually performed under general anaesthesia. In general, the procedure will go as follows:

To begin, anyone undergoing cheekbone reduction surgery, also known as zygoma reduction plasty, must be thoroughly evaluated to ensure they are physically and psychologically fit for surgery. To properly prepare for the reduction procedure, doctors will advise patients to abstain from alcohol and many medications prior to surgery.

A separate appointment will be scheduled prior to surgery for doctors to take X-ray images of the cheek area. This provides critical information about the shape and measurements of the bones to be reshaped (the maxilla and mandibular bones).

The majority of reductions involve "intraoral procedures," which refer to procedures performed inside the mouth. An incision in the gum lining will be made during this procedure to allow surgeons access to the cheekbones. However, an exterior incision just below the hairline may be necessary.

It is also generally necessary at this point to weaken the zygomatic bone by creating fractures at both ends. This enables surgeons to apply pressure to the bone, resulting in the desired shape.

The precise form of reshaping depends on the facial contours involved, but it usually involves cutting through the zygomatic arch with a surgical saw.

Following this, surgeons will be able to rotate and fold the bone. This reduces the width of the face as seen from the front while maintaining the general contours of the face as a whole. In the case of high cheekbones, rotation may not be necessary; instead, downward pressure may be applied.

In any case, titanium screws are required to apply pressure on the bones to reshape them until they are securely set in the correct position. Following the closure and dressing of any incisions, the recovery period begins.

 

What are the types of Zygomatic Reduction?

There are three main techniques for reducing cheekbones.

L-shaped Osteotomy

This technique is for people whose malar protrudes primarily from the front. A 2 cm incision will be made on the mouth mucous membrane. The body of the zygoma (cheekbones) will then be cut into a L shape with a special saw. Droopy cheeks can be corrected with additional surgery.

The approach for this surgery is either through a mouth incision or, in some cases, a mouth incision combined with a small external incision at the side burn area or in front of the ear canal. The prominent bony segment of the zygoma is shaved or cut to reduce its size.

After that, the surgically fractured zygoma is carefully moved inward, backward, and downward. Small plates and screws are used to secure the fractured zygoma after it has been repositioned. Zygoma reduction surgery can be performed as a standalone procedure or in conjunction with other facial contouring procedures such as mandibular angle reduction surgery to create an oval-shaped face.

This method calculates the maximal malar projection (MMP), after which the most protruded part of the cheekbone can be reduced. This results in a 30-90-degree wide area reduction of the cheekbone. The Low-L Osteotomy method places the cut or fracture on the bottom side of the zygoma, allowing only a 45-90-degree lateral area reduction. The end result of this method is a suboptimal reduction in the cheekbone.

 

Scalp Approach

This method is for people whose malar protrudes both frontally and laterally. Two incisions will be made: one on the upper temple area where hair grows and the other on the mouth membrane. These incisions will then be used to break the exposed cheekbones. The broken cheekbone piece will then be pushed inside and secured with wire.

 

Malar Rotation Technique

This technique is for people with malar protrusions that protrude laterally. The zygomaticomaxillary complex is rotated medially clockwise during this procedure. The bone contact will be improved, resulting in a reduction in the volume of the malar bones. The rotation will result in a more defined and smaller face, as well as the anterior malar coming up to the front.

 

What happens after Zygomatic Reduction surgery?

It is critical to use mouthwash on a regular basis to prevent infection. To reduce swelling, keep the face elevated as much as possible and wear the provided compression bandage at all times for three days and while sleeping for one month.

• Follow the postoperative instructions carefully 
• Head elevation, especially when sleeping, for 3-4 weeks 
• Take the prescribed medications as directed 
• Compressive dressing around cheek for 3-5 days
• Wound care for any external wounds
• Regular mouthwash or gargle after every meal if there are any oral wounds
• Soft diet for 2-3 weeks 
• Avoid strenuous physical activities for 3-4 weeks 
• Avoid aggressive activities for a month after surgery
• Do not smoke or drink alcohol for at least two weeks after surgery.
• Keep any follow-up appointments with your surgeon to monitor the healing process and to ask any questions you may have.

You can return to work 7-10 days after surgery, but there may still be some swelling. You can resume exercising four weeks after surgery.

The patient may experience pain, numbness, bruises, and swelling around the cheeks during the initial healing phase. Occasionally, the patient may feel tightness when opening his or her mouth. These symptoms are temporary and usually last 3-4 weeks.

Sutures in the side burn areas or in front of external ear canals are usually removed 7-10 days after surgery. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain, respectively.

The final shape of your facial contours will be visible within a few weeks of surgery. At this point, you should expect to schedule follow-up appointments with your cosmetic surgeon to assess how the procedure went and whether any additional attention is required. In some cases, reduction surgery can result in asymmetry, scarring, and nerve damage, and experts will want to catch any problems as soon as possible.

Additional surgery is uncommon but may be required in a small number of cases. Furthermore, some patients report that botox or other cosmetic procedures are required to treat sagging in the cheek area. The majority of cheekbone reduction patients, however, do not have this experience.

 

What are the possible complications of Zygomatic Reduction surgery?

Zygoma reduction, like other facial reduction procedures, carries risks, both common surgical risks and risks specific to the procedure.

Typical surgical risks include:

• Infection
• Bleeding
• Blood Clot 
• Bruising
• Swelling 
• Injury to the surrounding muscles, bones, nerves, or blood vessels 
• Allergic reactions to the anesthetics used

Risks specific to zygoma reduction (or a closely related procedure) may necessitate revision surgery. They are as follows:

• Skin sensation changes or decreases over the surgical area that may or may not be temporary 
• Asymmetry between the two cheekbones
• Body contour irregularity
• Tightness in opening the mouth
• Bone disunion of the zygomatic arch
• Weakening of the zygomatic arch
• Zygomatic bone and arch defect or displacement after surgery

In addition to these risks, patients can expect to experience post-operative pain around the cheeks. Oral antibiotics and analgesics are commonly prescribed to alleviate pain and prevent infection. Patients are given strict post-operative instructions, including the requirement to sleep with their heads elevated for the first four weeks after the procedure. Because the incision is intraoral, patients are also taught how to wash and clean their mouths to prevent infection. 

 

Zygomatic Reduction cost

The cost of your procedure will be determined by several factors, including facility and surgeon fees, as well as anaesthesia costs. During your consultation, you will be given a price estimate. Financing is available.

The price range is difficult to determine because many factors all play a role. These include the clinic's level, the difficulty of the case, the length of the surgery, and the level of doctor within the clinic. Is the doctor, for example, a specialist? What kind of experience does he have? How frequently do they carry out the procedure?

With that said, and remembering that all of these factors play a role in the price range, the price range for Zygomatic reduction surgery is around 4000 USD to 9000 USD. Paying the highest price is not always necessary, but it depends on your circumstances. Similarly, because they are in high demand and have full schedules, expert doctors will not want to perform surgeries at the lowest price points.

Apart from the surgery, the total cost of the procedure includes the costs of materials used, anesthesia, medicines, hospital facilities, and so on. Because the cost of all of these varies by location, the total cost of cheekbone reduction surgery differs from one location to the next. A typical cheekbone reduction surgery in the United States can cost between $3500 and $5,000 USD.

The cost in the UK is slightly lower than in the US, but it is still very high, and the majority of people cannot afford it. This surgery may cost between $1800 and $3000 USD. However, even after factoring in travel costs and other expenses, travelling abroad for the procedure can save you a significant amount of money. Cheekbone reduction costs around 1250 USD in Brazil, but only 850 USD in the UAE.

Prices are even lower in India and Thailand, where you can get the cheeks you want for as little as 600-700 USD. This surgery is the most affordable in Mexico, with prices ranging from $250 to $300 USD in cities such as Tijuana. If you are interested in medical tourism, choose one of these countries to get lower prices with guaranteed quality healthcare standards.

 

Conclusion

A large part of the face is determined by the cheekbone, also known as the Zygomatic or Zygoma bone. It shapes the face and thus determines the width of the face. This bone can be reduced and shaped to create a smaller protrusion and a more balanced appearance.

While prominent cheekbones are usually a desirable trait, only cheekbone reduction surgery, also known as zygomatic reduction surgery, can slim them down. The bone is shaved during this surgical procedure to create more subtle contouring in the facial structure. For more dramatic results, the cheekbone can be broken and reshaped completely, or it can be moved with the help of small plates and screws.

A good candidate for this procedure is someone who has naturally wide cheekbones, very prominent cheekbones, or facial asymmetry and wants to soften or balance their face. According to some research, patients of Asian descent are more likely to have this type of facial contouring plastic surgery.

To gain access to the zygomatic bone, the surgeon will make one incision inside the mouth and one on the skin near the sideburns. If the bone is simply cut vertically, only a minor reduction in facial width is possible. Expert surgeons can make two distinct cuts to maximize the potential of your own body. High-L Osteotomy can occur in the first cut, near the nose.

The intraoral approach and L-shaped osteotomy for zygoma reduction can reduce prominent zygoma while preserving the natural curves of the zygomatic body and arch. This method will be regarded as a relatively desirable way due to its simple procedures, fewer complications, and excellent results.

It is critical for patients to understand that each surgical procedure has its own set of complications and risks. However, if a patient is properly assessed before surgery and adequate postoperative care is provided, these risks can be eliminated or reduced.

Temporary changes in skin sensation are normal, but sensation may be affected long-term. Asymmetry of the face, tightness around the mouth, and weakened cheekbones can all cause problems. This could necessitate additional corrective surgery.