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Simultaneous Reduction Malarplasty and Reduction Mandibuloplasty: Less Mandibular Hyperplasia with Masseter
Panxi Yu1, Qian Wu2, Mengdie Wei3
1Center of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
Simultaneous reduction malarplasty with zygomatic arch elevation reduces masseter muscle thickening and mandibular hyperplasia after reduction mandibuloplasty, improving aesthetic outcomes. This combined approach offers better results than mandibuloplasty alone.
Area of Science:
- Plastic Surgery
- Maxillofacial Surgery
- Aesthetic Surgery
Background:
- Bone hyperplasia post-reduction mandibuloplasty can necessitate revision surgery.
- Masseter muscle hypertrophy is a key factor in postoperative mandibular hyperplasia.
- Clinical observations suggest combining reduction malarplasty with zygomatic arch elevation may mitigate masseter accumulation and subsequent mandibular hyperplasia.
Purpose of the Study:
- To evaluate the efficacy of simultaneous reduction malarplasty with zygomatic arch elevation in preventing masseter muscle accumulation and mandibular hyperplasia after reduction mandibuloplasty.
- To compare outcomes between patients undergoing combined procedures versus reduction mandibuloplasty alone.
Main Methods:
- Retrospective review of patients from September 2015 to April 2024.
- Analysis of computed tomography data to measure mandibular volume changes (preoperative, immediate postoperative, follow-up).
- Calculation of resected and regenerated mandibular bone volume, masseter thickness, and zygomatic arch elevation distance.
Main Results:
- The combined-operation group (n=52) showed significantly less masseter thickening (0.89 ± 1.21 mm) compared to the single-operation group (n=35) (2.70 ± 1.10 mm).
- The single-operation group experienced more severe masseter thickening and mandibular hyperplasia.
- Masseter thickening correlated positively with mandibular resected volume, and mandibular hyperplasia correlated positively with masseter thickening.
Conclusions:
- Simultaneous reduction malarplasty with zygomatic arch elevation effectively reduces masseter redundancy and mandibular hyperplasia.
- This combined surgical approach, utilizing a bracing technique with zygomatic arch elevation, can enhance aesthetic results in reduction mandibuloplasty.
- Consideration of simultaneous procedures is recommended for improved outcomes in maxillofacial contouring.
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