Lee Sang Woo, Jeong Yeon Woo, Myung Yujin
D.A. Plastic Surgery Clinic, Seoul, Republic of Korea.
Slow Plastic Surgery Clinic, Jeju, Republic of Korea.
Aesthetic Plast Surg. 2017 Feb;41(1):161-170. doi: 10.1007/s00266-016-0723-9. Epub 2016 Dec 28.
Many patients undergo a revision surgery after malar reduction, which is one of the most popular aesthetic surgeries in Asia. We reviewed the leading causes of revision for malar reduction surgery to establish proper indications for revision, seek adequate surgical strategies, and share the results from revision surgical cases.
A retrospective review was conducted involving 341 patients who underwent malar reduction reoperation between March 2010 and June 2015. Surgical strategies were decided based upon specific problems and complaints from the previous surgery. Facial photographs, cephalography, and computed tomography images were analyzed, and a patient satisfaction survey was conducted before and after the surgery.
A total of 341 patients (321 women, 20 men; average age, 26.6 years, range 18-40 years) were included. The main causes of reoperations were subjective dissatisfaction and nonunion-related symptoms. Undercorrection of the zygomatic body and arch (n = 175, 51.3%) was the most frequent reason for dissatisfaction. The patients underwent revision surgeries via different techniques and strategies based on previous problems from primary surgery, and postoperative patient satisfaction was high. Complications occurred in 35 patients (10.3%) after revision.
Based on the results of this study, patient dissatisfaction with the procedure can be minimized beforehand through accurate goal identification and careful planning. Bone nonunion is usually due to excessive bone resection during zygoma reduction surgery. Careful selection of the reposition site and appropriate fixation based on a thorough understanding of masseter action are essential in ensuring satisfactory outcomes without adverse side effects.
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许多患者在颧骨缩小术后需要进行修复手术，颧骨缩小术是亚洲最受欢迎的美容手术之一。我们回顾了颧骨缩小术修复的主要原因，以确定修复的适当适应症，寻求合适的手术策略，并分享修复手术病例的结果。
对2010年3月至2015年6月期间接受颧骨缩小修复手术的341例患者进行回顾性研究。根据上一次手术的具体问题和患者诉求来决定手术策略。分析面部照片、头颅侧位片和计算机断层扫描图像，并在手术前后进行患者满意度调查。
共纳入341例患者（321例女性，20例男性；平均年龄26.6岁，范围18 - 40岁）。再次手术的主要原因是主观不满意和骨不连相关症状。颧骨体和颧弓矫正不足（n = 175，51.3%）是最常见的不满意原因。根据初次手术的既往问题，患者通过不同的技术和策略接受修复手术，术后患者满意度较高。修复术后35例患者（10.3%）出现并发症。
基于本研究结果，通过准确确定目标和精心规划，可以预先将患者对手术的不满意程度降至最低。骨不连通常是由于颧骨缩小手术中过度切除骨质所致。在充分了解咬肌作用的基础上，仔细选择复位部位并进行适当固定，对于确保获得满意效果且无不良副作用至关重要。
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