Fatal Meningitis Following Reduction Malarplasty: A Previously Unreported Complication

Major complications after reduction malarplasty are uncommon and generally non-life-threatening, but intracranial infectious complications associated with this procedure have not been reported. This paper presents a fatal case of postoperative meningitis to highlight this potential risk. A 35-year-old woman presented with an altered mental status ~2 weeks after undergoing revisional reduction malarplasty. The imaging and laboratory findings were suggestive of bacterial meningitis with intracranial involvement. Although surgical details were unavailable, postoperative craniofacial imaging indicated the possibility of dural violation by the fixation hardware, which may have served as a direct conduit for infection. This case shows that reduction malarplasty, though generally safe, can lead to fatal intracranial infections, albeit rare. Careful surgical planning and accurate fixation are crucial for preventing inadvertent dural penetration, and early recognition of neurologic symptoms is essential to improve the outcomes.