Hong Seung Eup, Liu Si You, Kim Jeong Tae, Lee Jong Hun
From the *Dr. Hong's Aesthetic and Plastic Clinic; †Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University; ‡Department of Plastic and Reconstructive Surgery, Eulji General Hospital, College of Medicine, Eulji University; and §Eulji Medi-Bio Research Institute, Eulji University, Seoul, Republic of Korea.
J Craniofac Surg. 2014 May;25(3):758-61. doi: 10.1097/SCS.0000000000000759.
Because of the various defects of malarplasty, including a large incision, much bleeding, visible scars after the operation, and so on, caused by the conventional coronal incision or the temporal incision with the intraoral incision approach, the malarplasty by simple intraoral approach is an innovative development.
Through the intraoral approach and subperiosteal dissection, we can reach the osteotomy point on the zygomatic body directly and arrive at the osteotomy point at the zygomatic arch end along the medial side of the zygoma. A new L osteotomy is applied with the reciprocating saw. In addition, the osteotomy was performed on the zygomatic arch from the inside out with an angle of 20 degrees horizontally.
From 1997 to 2010, we were satisfied with the results of 114 cases of malarplasty with the intraoral approach and L osteotomy as the observed objects. There are 103 cases for women and 11 for men. Ages ranged from 16 to 48 years. The mean operation time is approximately 1 hour. We just had a few complications: 3 nonunion at the osteotomy line and needed a second surgery to repair as well as 2 slight cheek drooping during the initial period and required face lifting.
The method of intraoral approach and L-shaped osteotomy for zygoma reduction can reduce prominent zygoma while maintaining the natural curves of the zygomatic body and arch. Because of the simple procedures, fewer complications, and excellent results, this method will be considered a relatively desirable way.
Therapeutic, III.
由于传统冠状切口或颞部切口联合口内切口入路进行颧骨整形存在各种缺陷，包括切口大、出血多、术后瘢痕明显等，单纯口内入路颧骨整形是一种创新性发展。
通过口内入路和骨膜下剥离，可直接到达颧体的截骨点，并沿颧骨内侧到达颧弓末端的截骨点。使用往复锯进行一种新的L形截骨。此外，从内侧向外侧以水平20度角在颧弓上进行截骨。
1997年至2010年，以114例采用口内入路和L形截骨的颧骨整形手术结果为观察对象，我们对其结果满意。其中女性103例，男性11例。年龄范围为16至48岁。平均手术时间约为1小时。我们仅出现了一些并发症：3例截骨线不愈合，需要二次手术修复；2例在初期出现轻微面颊下垂，需要进行面部提升。
口内入路和L形截骨降低颧骨的方法在减少突出颧骨的同时可保持颧体和颧弓的自然曲线。由于手术操作简单、并发症少且效果良好，该方法将被认为是一种相对理想的方式。
治疗性，III级。
