Key Point for Successful Malar Reduction, Dual Fix Malar Reduction
Key Point for Successful Malar Reduction, Dual Fix
Malar Reduction
In Korea, so many patients are visiting plastic surgery to have a consultation about their cheekbone. The wide, huge, or protruded cheekbone makes the overall facial contour looks bumpy, gives a rough impression, or makes them look old since it takes up the middle of the face. Malar reduction is in the spotlight as a solution to improve the shape of the protruded cheekbone.
However,
there are several unsatisfied experiences from insufficient reduction effect or
facing side effects such as saggy cheek, nonunion, and so on that require
repetitive surgery. That’s why there are so many patients who hope to have it
done but cannot decide and only concerning to get it done or not.
“
The
most common unsatisfied experiences of malar reduction
insufficient reduction effect, saggy cheek, and nonunion
”
A CT image of the TS real patient
The limit of original L-osteotomy
“insufficient result and possibility of having saggy cheek”
The patient of the
above CT image had secondary surgery in TS due to an insufficient reduction
effect from the primary surgery. As you see, the patient had L-osteotomy but
the MMP (Maximal malar projection) was not included causing an insufficient
reduction effect. Moreover, the possibility of facing a saggy cheek goes higher
while desquamation between the bone and the skin goes on for the bone cutting
since the skin remains same compared to the bone that became smaller.
A CT image of the TS real patient
Dual-Fix
L-osteotomy, pushing together with the MMP inward and mitigate the damage of
the retaining ligaments
On
the other hand, dual-fix L-osteotomy cuts the cheekbone including the MMP the
nearest to the eye socket and rotates and moves the fractured bone to maximize
the reduction effect. In addition, it lessens the possibility of facing a saggy
cheek by minimizing the desquamation and the damage of the retaining ligaments.
‘Double
fixation’ to reduce the possibility of having a nonunion and vicious union
We
need to pay attention to not only the reduction effect or saggy cheek but also nonunion and vicious union. If the fractured bone
is not firmly fixed during surgery, the masseter muscle that is located
underneath the cheekbone and moves every time we eat, speak and make a facial
expression shakes the cheekbone that might end up having the most common side
effects such as a nonunion and vicious union.
Continuing
with the nonunion and vicious union, the second point of the successful malar
reduction is the strong fixation with the proper placement. It is possible to
prevent those to be happened by placing the fractured bone after pushing inward
to the right angle into the perfect size of the secured space while proceeding
with osteotomy and fixing tight.
It is important to use the plate that is widely used to fix the bone with the wire due to its low pulling capacity to fix tight and strong. The double fixation is the main point to focus on to keep the cheekbone without any movement caused by muscles so that the fractured bone repositions into the correct place to prevent any side effects in the future.
A pleasing result of
the malar reduction is not about cutting and pushing much of the bone, it is
about “How osteotomy goes”, and “How the fixation is done after osteotomy”. It
is essential to look at safety to decide to have a malar reduction that
requires a high surgical technique dealing with the facial bone directly. An
accurate diagnosis should be done by the specialist who has a great
understanding of facial contouring surgery and extensive experience with the
technique. Moreover, we recommend you consider the system that the clinic has
to proceed with a safe operation such as a live CCTV monitoring system, a continuous
care system for complications that occurred post-operation, and etc.
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