Correction of Nonunion of Zygoma Body after Aesthetic Reduction Malarplasty

ABSTRACT

The Asian face is generally shorter and wider than western face whose face is dolichocephaly. Therefore the reduction malarplasty is one of the common aesthetic surgery performed in Asians. As the number of cases of aesthetic reduction malarplasty including osteotomy technique of zygoma body increase, the complications related to the osteotomy also increase. Among the various complications, if the ostotomized zygoma body does not heal or reunite, it may cause a serious problem not only to the surgeon but also to the patients. From June 2002 to July 2003, the authors experienced 5 patients whose zygoma body did not reunite after reducing their malar prominence at other clinic. Their major complains were subjective discomfort at the operated site, depression on malar eminence, abnormal click sound on mouth opening, etc. None of them had any evidence of rigid fixation on their osteotomy of the zygoma body. The Rib bone was harvested and grafted to the bone gap due to the nonunion of zygoma body. All grafted bones were rigidly fixed and survived. In conclusion, bone to bone contact without soft tissue impingement should be preserved for the bone healing after zygoma body osteotomy. Therefore the rigid fixation method of osteotomy is the fundamental element during the operation. The rib bone interpositional graft can be one of the solution methods in the unfortunate nonunion cases.