Department of Aesthetic Plastic Surgery, Huangsi Aesthetic Surgery Hospital, 9 Huangsi Street, Beijing, 100010, People's Republic of China.
Aesthetic Plast Surg. 2013 Aug;37(4):692-6. doi: 10.1007/s00266-012-0033-9. Epub 2013 Jan 8.
Reduction malarplasty via an intraoral approach for correction of a prominent malar complex is quite popular in the Orient. However, one point of fixation in the anterior zygoma body area, the most widely used method, sometimes is insufficient and likely to result in malunion and cheek drooping. We designed a new assisted fixation technique to strengthen the effect of fixation.
Two parallel oblique vertical ostectomies were performed on the zygomatic body with a groove left in the inner osteotomy line. The zygomatic arch root was cut obliquely through a small sideburn incision just in front of articular tubercle, medial to lateral and anterior to posterior. The freed malar complex was medially and superiorly repositioned with the zygomatic body wedged in the groove, followed by fixation with one miniplate or wire. Finally, the periosteum in the zygomatic area was pulled and sutured to the deep temporal fascia.
Most patients were satisfied with their results. No inferiorly displaced malunion occurred in the zygomatic body. There were no serious complications such as nonunion or permanent facial nerve injury. Minor complications, including palpable step-off, mild asymmetry, hematoma, and mild cheek drooping, occurred in some cases.
Our assisted fixation method, combined with subperiosteal lifting, can provide ideal effects and sufficient fixation in malar reduction to prevent many complications such as malunion and cheek drooping.
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经口入路颧骨缩小术用于矫正突出的颧骨复合体在东方国家非常流行。然而，在颧骨体区域最广泛使用的固定点之一，有时是不够的，并且可能导致愈合不良和脸颊下垂。我们设计了一种新的辅助固定技术来增强固定效果。
在颧骨体上进行两条平行的斜向垂直截骨术，在内部截骨线处留下一条凹槽。颧骨弓根通过关节结节前小鬓角切口斜行切开，从前向后，从内侧到外侧。游离的颧骨复合体向内和向上重新定位，颧骨体楔入凹槽中，然后用一块小钢板或线固定。最后，将颧骨区域的骨膜向上拉并缝合至颞深筋膜。
大多数患者对结果满意。颧骨体没有出现向下移位的愈合不良。没有出现非愈合或永久性面神经损伤等严重并发症。少数病例出现轻微并发症，包括可触及的台阶、轻度不对称、血肿和轻度脸颊下垂。
我们的辅助固定方法，结合骨膜下提升，可以在颧骨缩小术中提供理想的效果和充分的固定，以防止愈合不良和脸颊下垂等许多并发症。
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