Three-dimensional facial soft-tissue changes after L-shaped reduction malarplasty: A pilot retrospective study

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Facial Anatomy

Background:

• Reduction malarplasty (RM) is a prevalent facial contouring procedure in East Asia.
• Limited data exists on postoperative soft tissue changes and patient-reported outcomes following RM.
• Understanding these changes is crucial for managing patient expectations and surgical planning.

Purpose of the Study:

• To evaluate soft-tissue alterations after L-shaped RM.
• To assess patient-reported outcomes and satisfaction post-RM.
• To compare soft-tissue changes in RM patients versus genioplasty controls.

Main Methods:

• Retrospective analysis of 55 patients undergoing L-shaped RM and 55 controls undergoing genioplasty.
• Computed tomography (CT) and 3D stereophotogrammetry for soft and skeletal tissue analysis.
• FACE-Q and Wrinkle Severity Rating Scale (WSRS) for patient-reported outcomes.

Main Results:

• RM led to significant inward soft tissue reduction in zygoma and cheek regions, with outward paranasal augmentation.
• Significant differences in soft-tissue changes were observed between RM and control groups.
• Skeletal tissue showed significant reduction, correlating with soft tissue changes; patient satisfaction improved despite some WSRS grade increases.

Conclusions:

• RM results in inward soft tissue depression and outward paranasal protrusion, suggesting potential soft tissue sagging.
• While some patients experienced increased nasolabial fold severity, overall aesthetic self-evaluation was positive.
• Surgeons and patients should consider both skeletal and soft-tissue dynamics for effective RM planning and expectation management.