Enhanced Midface Contouring: Simultaneous Zygomatic Reduction and Partial Coronoidectomy for Optimal Aesthetic and Functional Outcomes.

BACKGROUND

The zygomatic complex plays a key role midfacial contour. In many Asian cultures, a softer facial appearance is preferred, making prominent zygoma less desirable. While reduction malarplasty is effective for contouring, it can lead to restricted mouth opening, potentially due to impingement from an elongated coronoid process. This study evaluates the outcomes of simultaneous reduction malarplasty and partial coronoidectomy to address both aesthetic and functional concerns.

METHODS

A retrospective analysis was conducted on the patients who underwent simultaneous reduction malarplasty and partial coronoidectomy. Preoperative and postoperative assessments included FACE-Q scores, maximal interincisal opening (MIO) measurements, and CBCT imaging. An L-shaped osteotomy technique and oblique coronoid resection were utilized. Outcomes were assessed based on functional metrics and patient-reported satisfaction.

RESULTS

A total of 27 patients (6 males and 21 females) were included in the final analysis. Facial contouring goals were successfully achieved in all patients, during an average follow-up period of 8.3 months, no major complications were observed. MIO remained stable (preoperative: 39.27 mm; postoperative: 39.38 mm). FACE-Q scores significantly improved from 39.58 to 75.04 (p < 0.001), reflecting high patient satisfaction with facial aesthetics and function.

CONCLUSIONS

Simultaneous reduction malarplasty and partial coronoidectomy is a safe and effective approach that prevents postoperative restricted mouth opening and enhances aesthetic outcomes. This combined strategy offers a proactive solution for patients at risk of coronoid-zygomatic impingement and should be considered in selected cases to optimize both functional and cosmetic results.

LEVEL OF EVIDENCE IV

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