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06 July 2015 : Clinical Research

A New Infracture Technique for Reduction Malarplasty with an L-Shaped Osteotomy Line

Li-Xin LinBCDEF, Ji-Long YuanBCDEF, Yu-Ting WangBCD, Yong HuangABCDEFG, Peng WangBDF, Xue-Ming WangCDE

DOI: 10.12659/MSM.893503

Med Sci Monit 2015; 21:1949-1954

Abstract

BACKGROUND: Reduction malarplasty is one of the most common surgical procedures performed in the Asian population for aesthetic purposes. Although multiple methods have been developed for reduction malarplasty, including a variety of infracture techniques, most of the current procedures have limitations. In the current study we created a new infracture method to circumvent these shortcomings.

MATERIAL AND METHODS: Between January 2004 and October 2013, we applied this novel infracture technique in 700 patients. The highest area of the zygomatic body was marked pre-operatively and ground intra-operatively through an intraoral incision. An L-shaped incomplete osteotomy of the zygomatic body was performed with a reciprocating saw, and then a complete perpendicular osteotomy (1 cm anterior to the articular tubercle of the zygomatic arch) was made through a pre-auricular incision. Light pressure on the posterior part of the arch produced a greenstick fracture of the anterior osteotomy site, resulting in posterior-inward repositioning of the malar complex. Internal fixation was not required.

RESULTS: Satisfactory aesthetic results and good post-operative stability were achieved. Three months post-operatively, the bone around the zygomatic arc osteotomy line was remodeled. The bone posterior to the articular tubercle of the zygomatic arch was partially absorbed, leading to a depression of the root of the arc and a natural transition on both sides of the osteotomy line, making the midface more slender. Instead, the anterior bone presented with new bones, making the malar complex more stable.

CONCLUSIONS: This new method has multiple advantages, including simple manipulation, no need for internal fixation, short operative and recovery times, and few complications. X-ray images showing the bony changes demonstrated that the infracture technique is an effective and ideal method for reduction malarplasty.

Keywords: Adult, Osteotomy - methods, Postoperative Complications, Surgery, Plastic - methods, young adult, Zygoma - surgery

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750