title: A New Infracture Technique for Reduction Malarplasty with an L-Shaped Osteotomy Line.
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.
  
  
  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.
authors.affiliation: Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai, Shandong, China (mainland).
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Lin
authors.affiliation: Department of Plastic and Aesthetic Center, People's Hospital of Liaoning Province, Shenyang, Liaoning, China (mainland).
authors.forename: Ji-Long
authors.initials: JL
authors.lastname: Yuan
authors.affiliation: Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai, Shandong, China (mainland).
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Wang
authors.affiliation: Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai, Shandong, China (mainland).
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai, Shandong, China (mainland).
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai, Shandong, China (mainland).
authors.forename: Xue-Ming
authors.initials: XM
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D013518:Surgery, Plastic / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult; D015050:Zygoma / Q000000981:diagnostic imaging / Q000601:surgery*