Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

Dr. Park Jong-chul, a specialist in oral and maxillofacial surgery, analyzes the CT scans of a male patient who underwent a 3-piece facial contouring surgery (zygomatic reduction, mandibular angle reduction, and genioplasty) 3 years prior. This post focuses on the changes in the zygomatic bone over time.

Pre-operative Analysis

Male Zygomatic Reduction 3 Years Later

The patient presented with a slight deviation of the chin to the right (1.91mm), and the left zygomatic width was 2.4mm wider than the right. The mandibular angle reduction was planned to position the angle approximately 20mm below the earlobe. The patient desired correction of chin asymmetry, a long face, and prominent cheekbones.

Surgical Plan

• Genioplasty: 5mm reduction in length, 2mm advancement (using a 2mm metal plate), 3mm reduction in width.

• Mandibular Angle Reduction: Preserve the angle as much as possible while performing mandibular angle reduction (20mm below the earlobe), and cortical bone resection to improve asymmetry.

• Zygomatic Reduction: 3mm bone resection at 45 degrees, 3mm medial movement of the 45-degree zygoma, and 6mm reduction of the lateral zygoma (based on the metal plate size).

3-Year Post-operative Comparison: CT Analysis

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

A noticeable reduction in facial length and width is observed (red rectangle in the image). Interestingly, the neck appears thicker. The 45-degree lateral view clearly shows a decrease in facial length (red line).

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

In the lateral image, it can be seen that the mandibular angle (jaw angle) has moved slightly upward compared to before the surgery, and the chin has become shorter vertically and protrudes forward.

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

3 Years After Zygoma Reduction: How Has the Bone Changed?

• Frontal CT: No significant changes in bone structure are observed. Zygomatic width remains stable.

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

• 45-degree CT: Smooth union of the osteotomy site (red arrow).

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

• CT Overlap:  Minimal widening of the zygomatic bone is observed, barely noticeable to the naked eye.

Male Zygomatic Reduction 3 Years Later: CT Analysis Reveals Bone Changes

Zygomatic Reduction 3 Years

• Lateral Zygoma: Bone coverage over the metal plate is evident (red arrow).

lateral zygoma reduction and step-off

Lateral Zygoma Reduction and Step-off

This case demonstrates that a step-off (irregularity) after lateral zygoma reduction (red dotted line) can smooth out over time without additional bone shaving

lateral zygoma reduction and step-off

The 3-year follow-up shows a smooth contour in the corresponding soft tissue area.

step-off smoothening

Long-term Safety and Stability

The 3-year CT analysis confirms the stability of the zygomatic bone and proper healing of the surgical sites, demonstrating the long-term safety of male zygomatic reduction.

Conclusion

This case study provides valuable insights into the long-term skeletal changes following male zygomatic reduction. It highlights the natural smoothing of step-offs in lateral zygoma reduction over time, potentially reducing the need for additional procedures.