Prevention of Cheek Drooping in Intraoral Reduction Malarplasty without Internal Fixation

ABSTRACT

PURPOSE: In general, orientals including Korean, have a mesocephalic face whereas Caucasians, among the western, have a dolichocephalic face .Unlike the western, in orientals including Korean, prominent malar bones are recognized as stubborn and unattractive appearance. That is why reduction malarplasty is one of the most popular aesthetic surgical procedure in Korea. Many surgical methods to reposition prominent malar bones have been performed by means of a coronal incision or a combined incisions, using both the intraoral and the external incision. Bicoronal approach has advantage such as wide operative field, easy to maintain symmetry and possibility of combining facial lift but has shortcoming, such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral approach has advantages of short operative time, simplicity of procedure and no external scar. But this approach is associated with problems of cheek drooping, limited exposure and difficulty in making symmetry. METHODS: During 8 years, we performed a reduction malarplasty without internal fixation through an minimal intraoral incision and dissection in 39 patients. RESULTS: The patients were followed for 46 months, with satisfactory results and no cheek drooping. There was no patient who want to revise the inappropriate operative result such as asymmetry and incomplete correction. CONCLUSION: We conclude that minimal intraoral incision and dissection could acquire satisfactory result of reduction malarplasty along with prevention of cheek drooping.