Patient-specific approach to the correction of a post-traumatic zygomatic deformity

Fractures of the zygomaticomaxillary complex (ZMC) represent one of the most frequent midfacial injuries and, if untreated, can result in significant functional and aesthetic sequelae. While open reduction and internal fixation is the standard of care for acute fractures, late presentations remain challenging due to bone remodelling and altered anatomical landmarks. Secondary corrective options include skeletal repositioning via zygomatic osteotomy or implant-based camouflage.We present the case of a young female patient with a displaced ZMC fracture left untreated following urgent cranioplasty abroad. Two months later, she underwent corrective surgery using patient-specific cutting guides, osteotomies and custom fixation plates through a swinging-eyelid and intraoral approach. The procedure successfully restored midfacial symmetry and orbital volume.This case highlights the value of patient-specific surgical planning, multidisciplinary collaboration and careful osteotomy technique in the management of post-traumatic delayed ZMC deformities.