Why Cheekbones Appear More Prominent After Jaw Reduction Surgery

Many individuals considering jaw reduction surgery (also known as mandible angle reduction) often wonder if they should undergo cheekbone reduction surgery (zygoma reduction) simultaneously. While the order of procedures doesn't significantly impact functionality, it's crucial to understand that jaw reduction surgery alone can make cheekbones appear more prominent.

The Interplay of Jaw and Cheekbones

The masseter muscle, responsible for chewing, connects the jaw and cheekbones. The size of these bones is heavily influenced by this muscle. A well-developed masseter muscle, often associated with a strong jawline, can contribute to the appearance of larger cheekbones. Conversely, after jaw reduction surgery, reduced chewing activity can lead to masseter muscle atrophy, potentially making cheekbones seem more pronounced.

The Impact of Weight Loss

Weight loss, particularly after jaw reduction surgery, can further accentuate cheekbones. This is because:

• Facial Fat Reduction: Weight loss leads to a decrease in facial fat, including the area around the cheekbones, making them more defined.

• Masseter Muscle Atrophy: As mentioned earlier, reduced chewing activity post-surgery can lead to masseter muscle atrophy, further contributing to the prominence of cheekbones.

Case Study: Before & After Jaw Reduction Surgery

Let's examine a real-life example. The images below show a patient before and 3 months after jaw reduction surgery.

• Before: The cheekbones don't appear prominent in the frontal view, but the axial view reveals developed cheekbones.

  

  Case Study: Before & After Jaw Reduction Surgery

• After: Despite only undergoing jaw reduction, the width above and below the cheekbones has decreased, making them more prominent.

  

  angle reduction surgery 3-month
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  Jaw Reduction Surgery 3-month

• Weight Loss: The patient lost 3kg and 3% body fat after surgery, further contributing to the prominence of cheekbones.

  
  

• Cross-sectional Change: Before the surgery, the side profile was straight (as indicated by the yellow line), but after the surgery, while the width of the cheekbone itself (yellow arrow) remained the same, changes can be seen in the areas above and below it.

  

  Jaw Reduction Surgery

The Correlation Between Weight, Masseter Muscle, and Chewing Force

The slimming effect of jaw reduction surgery is linked to masseter muscle atrophy. This muscle, along with the temporalis muscle (both being part of the muscles of mastication), shrinks due to decreased chewing activity. The reduction in temporalis muscle volume can make cheekbones appear more prominent by reducing the volume around them.

This is because chewing activity, often associated with increased food intake, directly influences muscle development. Therefore, weight and masseter muscle size tend to be proportional.

However, weight loss and masseter muscle reduction are not always directly proportional.  

Despite weight loss, increased chewing force can lead to masseter muscle hypertrophy. Habits like teeth grinding or clenching can also contribute to masseter muscle development, independent of chewing activity.

What Happens with Post-Surgery Weight Gain?

In cases where patients gain weight after jaw reduction surgery, increased fat deposition around the temples can be observed.

Patient with weight gain after jaw reduction surgery

Conclusion

The increased prominence of cheekbones after jaw reduction surgery is due to the close relationship between the jaw and cheekbones, coupled with post-surgical weight loss and mastication (chewing muscles) atrophy.

Therefore, if you're considering jaw reduction surgery, it's crucial to be aware of this potential outcome and consider cheekbone reduction as a complementary procedure.

Why Cheekbones Appear More Prominent After Jaw Reduction Surgery