Park Sanghoon
Department of Plastic Surgery, Center for Facial Bone Surgery, ID Hospital, Seoul, Korea.
Facial Plast Surg. 2020 Oct;36(5):613-622. doi: 10.1055/s-0040-1717143. Epub 2020 Dec 24.
Zygoma reduction is indicated in patients where the primary aim of surgery is reduction in the width of cheekbones to achieve smoother and more feminine facial aesthetic lines. Surgeons should evaluate the width of midface (bizygomatic width) and the protrusion of zygoma (volume and position of the zygomatic body) when evaluating patients where such a procedure is indicated. Intraoral high-L osteotomy is the most useful method to successfully treat a wide spectrum of zygomatic protrusions and is widely accepted as the treatment of choice for aesthetic purposes. The amount of ostectomy is determined by evaluating the volume of zygomatic body. The zygomatic body and arch are usually moved posteromedially during surgery; the point of maximal malar projection is evaluated and transposed to a new ideal position. Zygoma reduction can be performed solely or in combination with other facial bone contouring procedures such as mandible reduction, genioplasty, or forehead augmentation. Soft tissue sagging, nonunion, malunion, and paresthesia are the most common complications of this procedure. Undercorrection and asymmetry are the most common aesthetically unfavorable sequelae and should be carefully prevented by proper preoperative planning and meticulous execution of surgical technique.
颧骨缩小术适用于那些手术主要目的是减小颧骨宽度以获得更平滑、更具女性化面部美学线条的患者。在评估适合进行此类手术的患者时，外科医生应评估中面部的宽度（双侧颧骨间距）以及颧骨的突出程度（颧骨体的体积和位置）。口内高位L形截骨术是成功治疗各种颧骨突出的最有效方法，并且作为美容目的的首选治疗方法被广泛接受。截骨量通过评估颧骨体的体积来确定。手术过程中，颧骨体和颧弓通常向后内侧移动；评估最大颧骨突出点并将其转移到新的理想位置。颧骨缩小术可以单独进行，也可以与其他面部骨骼轮廓整形手术联合进行，如下颌骨缩小术、颏成形术或额头增高术。软组织下垂、骨不连、骨愈合不良和感觉异常是该手术最常见的并发症。矫正不足和不对称是最常见的美学上不利的后遗症，应通过适当的术前规划和精心执行手术技术来仔细预防。
