Wang Tailing, Gui Lai, Tang Xiaojun, Liu Jianfeng, Yu Dashan, Peng Zhe, Song Bin, Song Tao, Niu Feng, Yu Bing
Beijing, China From the Plastic Surgery Hospital of Chinese Peking Union Medical College, Chinese Academy of Medical Sciences.
Plast Reconstr Surg. 2009 Oct;124(4):1245-1253. doi: 10.1097/PRS.0b013e31819e6562.
Oriental people usually have a wide midface and a prominent zygoma. Reduction malarplasty is one of the most frequently requested procedures for improvement of the facial contour in the Orient. Some methods involve coronal or preauricular incision for osteotomy, but this increases the likelihood of skin scars and injury to facial nerves, and increases the duration of surgery. Some methods involve an intraoral approach but cannot control the degree of reduction or the precision of interosseous fixation with the designed osteotomy lines. The authors designed an L-shaped osteotomy for malar prominence reduction through an intraoral approach to overcome these shortcomings.
The authors reviewed 418 patients who underwent an L-shaped osteotomy for malar reduction performed in their department between 1997 and 2007. Follow-up was from 6 to 60 months (average, 12 months). The authors analyzed the rate of complications and evaluated the therapeutic efficacy of their method.
Four hundred two patients (96.2 percent) were satisfied. Only 16 patients (3.8 percent) with late complications were dissatisfied. Late postoperative complications focused mainly on asymmetry and cheek drooping.
The new L-shaped osteotomy for correction of prominent zygoma is an ideal method, with the advantages of simpler manipulation, fewer complications, better outcome, shorter operative duration, no skin scars, and integrity of the structural characteristics of the zygoma.
东方人通常面部中部较宽，颧骨突出。颧骨缩小整形术是东方人改善面部轮廓最常要求实施的手术之一。一些方法需要冠状切口或耳前切口进行截骨，但这增加了皮肤瘢痕形成以及面神经损伤的可能性，还延长了手术时间。一些方法采用口内入路，但无法控制截骨程度或按照设计的截骨线进行精确的骨间固定。作者设计了一种通过口内入路的L形截骨术来缩小颧骨突出，以克服这些缺点。
作者回顾了1997年至2007年在其科室接受L形截骨术缩小颧骨的418例患者。随访时间为6至60个月（平均12个月）。作者分析了并发症发生率并评估了该方法的治疗效果。
402例患者（96.2%）满意。仅16例（3.8%）出现晚期并发症的患者不满意。术后晚期并发症主要集中在不对称和面颊下垂。
用于矫正颧骨突出的新型L形截骨术是一种理想的方法，具有操作更简单、并发症更少、效果更好、手术时间更短、无皮肤瘢痕以及保留颧骨结构特征完整性等优点。
