Intraoral Reduction Malarplasty without Internal Fixation

ABSTRACT

The concept of the Asian facial beauty is different from that of the western. Caucasians, especially among the western, consider prominent malar bones as a sign of youth and beauty. But in Orientals including Koreans, prominent malar bones are recognized as unattractive. Until recently, operations to reposition prominent zygoma have been performed by means of a coronal incision or a combined approach, using both the intraoral and the external(preauricular, temporopreauricular or side burn) incision. Such incisions have shortcomings such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral incision alone is associated with problems such as cheek drooping, limited exposure in the area of zygomatic arch, and difficulty in making symmetry of the cheek. During the past 4 years, we performed a reduction malarplasty without internal fixation through an intraoral incision alone in thirty-six patients who have prominent zygoma, mainly lateral projection of the zygoma. Osteotomy of the zygomatic arch was done posteromedially using a 120 degrees-angled oscillating saw, 1cm anterior to the articular tubercle and then osteotomy of the zygomatic body was done using a reciprocating saw. After complete osteotomy and posteromedial reduction, fixation using miniplate or wire was not done. The patients were followed for 14 months, with satisfactory results and few complications. We conclude that this technique is a simple and effective method of conduction an intraoral osteotomy and reduction malarplasty without internal fixation.