title: Reduction malarplasty by bidirectional wedge ostectomy or two percutaneous osteotomies according to zygoma protrusion type.
abstract: BACKGROUND
  Reduction malarplasty to correct prominent malar complex is popular in Asians. Despite the popularity of reduction malarplasty, most of the surgical methods applied are not selected according to the degree of zygoma protrusion. In this study, we analyzed the effectiveness of two different surgical procedures to clarify their appropriateness for each zygoma type.
  
  
  METHODS
  One of the procedures used was the "bidirectional wedge ostectomy," in which a bidirectional wedge-shaped bone fragment was removed from the zygomatic body via oral incision and oblique complete osteotomy of the zygomatic arch via sideburn incision. Another was the "quick osteotomy," a greenstick osteotomy of the zygomatic body and complete osteotomy of the zygomatic arch via two skin incisions. We classified zygoma protrusion into two categories: only zygomatic arch protrusion (group 1) and zygomatic body and arch protrusion (group 2).
  
  
  RESULTS
  The cross-sectional area of the most prominent malar region decreased by 9.4 ± 2.5 mm laterally (zygion-to-zygion) and by 2.9 ± 0.8 mm obliquely (average of center-to-right and left maxillozygion) after the ostectomy. However, in patients who underwent the osteotomy, while the cross-sectional area decreased by 10.9 ± 2.7 mm laterally, it did not decrease obliquely. Thirty patients (73.2%) in group 1 underwent the osteotomy, and the remaining eleven (26.8%) underwent the ostectomy. In group 2, 83% (n = 39) underwent the ostectomy.
  
  
  CONCLUSIONS
  We were able to find the more appropriate procedure for each zygoma protrusion type through outcome analysis. With these results, we suggest that if each procedure is performed according to this classification, more favorable esthetic results of zygoma reduction can be achieved.
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea.
authors: Wooyeol
authors: W
authors: Baek
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea.
authors: Taeyong
authors: T
authors: Woo
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea.
authors: Young Seok
authors: YS
authors: Kim
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea.
authors: In Sik
authors: IS
authors: Yun
authors: TL Plastic Surgery, Seoul, South Korea.
authors: Jimyung
authors: J
authors: Kim
authors: TL Plastic Surgery, Seoul, South Korea.
authors: Se Woon
authors: SW
authors: Choi
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: rohts@yuhs.ac.
authors: Tai Suk
authors: TS
authors: Roh
authors: Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, South Korea.
authors: Dae Hyun
authors: DH
authors: Lew
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods*; D055815:Young Adult; D015050:Zygoma / Q000601:surgery*
keywords: Facial bone contouring; Plastic surgery; Reduction malarplasty; Zygoma; Zygoma reduction