Malar augmentation using lamellar split osteotomy

Lamellar split osteotomy technique, when used in malar-zygomatic complex, presents a new and effective way of changing facial contour to obtain lateral or anterior projection and to improve facial aesthetics. This technique, an original invention of the author, provides new elements in the surgical correction of skeletal deformities. In contrast to classic osteotomies, this technique transforms the outer table into a maneuverable bone segment, the contour of which can be changed by bending, sliding, or rotation. In separating the outer from the inner table, the outer table becomes movable, whereas the inner table remains in place. A basic advantage of this technique is that the contour can be changed without using additional biological or nonbiological implants. Screws fix the outer table in its changed shape and position. During the last 6 years, 44 lamellar split osteotomies were performed; 22 were for advancement of the malar-zygomatic complex. Follow-up spanned from 6 months to 6 years. No resorption of bone or change of contour was observed at follow-up, which indicates that the outer table maintains its new contour and position during childhood and adolescent growth.