Hwang Chang Heon, Lee Myung Chul
Ilumi Plastic Surgery Clinic, 596 Gangnam-daero, Gangnam-gu, Seoul, South Korea.
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, South Korea; Department of Medicine, Yonsei University Graduate School of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, South Korea.
J Plast Reconstr Aesthet Surg. 2016 Jun;69(6):809-818. doi: 10.1016/j.bjps.2016.03.004. Epub 2016 Mar 23.
Broad or excessive malar protrusion is a trait associated with aggression and old age in Asian cultures. Although various methods of shifting the zygoma have been introduced for reduction malarplasty, soft tissue sagging and inadequate bony union still remain great challenges. We have devised an arch-lifting technique that helps overcome these issues. An analysis of surgical outcomes is presented herein.
A total of 54 patients subjected to lifting malar reductions between January 2013 and November 2014 were retrospectively reviewed. The reduction procedure entailed an L-shaped osteotomy of the zygomaticomaxillary junction via an intraoral approach. In addition, a prefabricated U-shaped microplate was applied for arch fixation in the lifted position. The follow-up period ranged from 6 to 18 months (average, 9.2 months), during which medical records, photographs, and facial bone computed tomography (CT) images were obtained to assess the postoperative results.
Patients were generally satisfied with aesthetic outcomes, thus rating the procedure excellent in terms of zygomatic prominence, midfacial width, symmetry, and resistance to cheek drooping. There were no major complications, such as facial nerve damage or trismus. An inadequate bony contact occurred in two instances due to unanticipated trauma, with immediate reduction and fixation thereafter. Minor wound infections developed in three patients but responded well to antibiotics.
Zygomatic reduction procedures must consider the dynamics of the adjacent muscles, which are stabilized through arch fixation. The use of our arch-lifting technique for reduction malarplasty efficiently elevates the zygomatic complex, thereby ensuring an adequate bone-to-bone contact. Predictable and accurate outcomes are thereby achieved.
在亚洲文化中，宽阔或过度的颧骨突出是与攻击性和衰老相关的特征。尽管已经引入了各种颧骨移位方法用于颧骨缩小整形术，但软组织下垂和骨愈合不足仍然是巨大的挑战。我们设计了一种弓状提升技术来帮助克服这些问题。本文介绍了手术结果分析。
回顾性分析2013年1月至2014年11月期间接受颧骨提升缩小术的54例患者。缩小手术通过口内入路对颧上颌连接处进行L形截骨。此外，应用预制的U形微型钢板在提升位置进行弓状固定。随访期为6至18个月（平均9.2个月），在此期间获取病历、照片和面部骨计算机断层扫描（CT）图像以评估术后结果。
患者对美学效果普遍满意，因此在颧骨突出度、面中部宽度、对称性和抗脸颊下垂方面对该手术给予高度评价。没有发生诸如面神经损伤或牙关紧闭等重大并发症。由于意外创伤，有两例出现骨接触不足，随后立即进行复位和固定。3例患者发生轻微伤口感染，但对抗生素反应良好。
颧骨缩小手术必须考虑相邻肌肉的动态，通过弓状固定使其稳定。使用我们的弓状提升技术进行颧骨缩小整形术可有效提升颧骨复合体，从而确保骨与骨的充分接触。从而实现可预测和准确的结果。
