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Revision reduction malarplasty with coronal approach.

Rong-Min Baek¹, Jino Kim, Sang Woo Lee

¹Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang, Seongnam, Gyeonggi 463-707, South Korea.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|February 16, 2010

Summary

Revision malarplasty using a coronal approach can achieve satisfactory outcomes for patients with complications from primary reduction malarplasty. Accurate repositioning and firm fixation of the malar complex are crucial for successful results.

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Area of Science:

Plastic Surgery
Aesthetic Surgery
Facial Reconstruction

Background:

Reduction malarplasty is a common aesthetic procedure, particularly in Asia.
Complications like non-union and malunion can arise from poor understanding of repositioning vectors or inadequate fixation.
Revision surgery is sometimes necessary to correct unfavourable outcomes.

Purpose of the Study:

To evaluate the effectiveness of revision malarplasty for correcting complications of primary reduction malarplasty.
To emphasize the importance of precise repositioning and secure fixation of the malar complex.
To highlight the utility of the coronal approach in revision cases.

Main Methods:

A cohort of 20 patients underwent revision malarplasty via a coronal approach.

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Complaints included cheek drooping, depression, asymmetry, and overcorrection.

The procedure involved repositioning the malar complex, rigid plate and screw fixation, and bone grafting for bony gaps. Associated procedures like midface and forehead lifts were performed as needed.

Main Results:

The majority of patients achieved satisfactory results with no severe complications.
Two patients required secondary revision for asymmetry and non-union.
Temporary frontal palsies occurred in three patients.

Conclusions:

Precise repositioning and firm fixation of the malar complex are essential for successful reduction malarplasty.
The coronal approach provides an adequate surgical field for revision malarplasty, facilitating effective repositioning and fixation.