Simultaneous malaroplasty with porous polyethylene implants and orthognathic surgery for correction of malar deficiency.
OBJECTIVE
Patients with skeletal malrelationships caused by maxillary anteroposterior defect and midface hypoplasia may present with an alteration of cheekbone contour. High osteotomies, segmental osteotomies of the zygomatic complex, and malar expansion with alloplastic materials can be performed to improve facial aesthetics. This article describes the restoration of cheekbone-nasal base-lip contour by performing a malaroplasty using an alloplastic implant in addition to orthognathic surgery.


METHODS
From 1995 to 1996, 17 patients with maxillomandibular malrelationships and deficient cheekbone contour were tested by malar augmentation with porous high-density polyethylene in association with maxillary advancement and mandibular setback. The diagnosis of cheekbone contour alteration was made after observing the patient from a lateral, frontal, and oblique point of view. The position of the implant was determined by using Mladick's point, with lateral or medial extension in relation to the depressed area.


RESULTS
By the restoration of normal cheekbone-nasal base-upper lip contour produced excellent aesthetic results in all patients.


CONCLUSIONS
Malaroplasty in association with bimaxillary orthognathic surgery seems to be an effective procedure for treating midface skeletal deficiencies.
Robiony
M
M
Department of Maxillo-Facial Surgery, Faculty of Medicine, University of Udine, P.le Santa Maria della Misericordia, Italy.
Costa
F
F
Demitri
V
V
Politi
M
M
D001672:Biocompatible Materials; D002610:Cheek / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D019931:Maxillofacial Prosthesis Implantation / Q000379:methods*; D010027:Osteotomy; D019340:Osteotomy, Le Fort; D011095:Polyethylenes; D019651:Plastic Surgery Procedures / Q000379:methods*; D015050:Zygoma / Q000002:abnormalities / Q000601:surgery*
D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes