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Revision malarplasty guided by strategic categorization.

Chang Heon Hwang1, Myung Chul Lee2

  • 1Ilumi Plastic Surgery Clinic, 596 Gangnam-daero, Gangnam-gu, Seoul 06038, Republic of Korea.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|December 6, 2018
PubMed
Summary

Revision malarplasty addresses complications from initial facial contouring surgery. Strategic assessments and techniques like zygomatic arch lifting improve skeletal stability and esthetic outcomes in revision cases.

Keywords:
CategorizationReductionRevisionZygoma

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Area of Science:

  • Plastic Surgery
  • Facial Reconstructive Surgery
  • Aesthetic Surgery

Background:

  • Reduction malarplasty is a popular procedure in East Asia for achieving a balanced facial profile.
  • Complications can arise from primary malarplasty, affecting bony structure and esthetics.
  • Revision malarplasty aims to correct these issues and improve facial balance and skeletal stability.

Purpose of the Study:

  • To examine the outcomes of revision malarplasty.
  • To identify common reasons for revision surgery.
  • To evaluate strategic assessments for achieving facial balance and skeletal stability in revision cases.

Main Methods:

  • A retrospective review of 97 patients undergoing revision malarplasty (December 2014 - November 2016).
  • Analysis of revision indications and categorization into three surgical groups.
  • Application of dual bone flap procedures, new osteotomies, and zygomatic arch repositioning.

Main Results:

  • Undercorrection was the primary indication for revision malarplasty, requiring additional repositioning.
  • Bony gaps (5-7 mm) in the zygomatic body/arch necessitated osteotomy and repositioning for continuity and contour.
  • Reconstructive bone grafts were used for significant bony defects and segmental resorption.

Conclusions:

  • Careful evaluation of complication causes is crucial before revision malarplasty.
  • Strategic patient categorization based on repositioning vectors and osteotomy needs is essential.
  • Zygomatic arch lifting via an intraoral approach offers predictable outcomes for structural stability in revision malarplasty.