Zygoma Augmentation Surgery

 

667. <Zygoma Augmentation Surgery>

Zygoma augmentation surgery is a cosmetic surgery performed to increase the volume of the zygomatic (cheekbone) area when the midface region is underdeveloped. It is mainly found among Westerners, where the zygomatic bone area is less developed, making the midface appear flat and lacking volume, prompting the surgery to add dimensionality.

The zygomatic bone is a structure that extends from the center of the face to the side, playing an important role in determining the contour and three-dimensionality of the face. In East Asians, it is relatively more developed, while in Westerners, it is relatively less developed. There are various reasons for this, but one explanation is that East Asians tend to have a brachycephalic (short-headed) skull shape, while Westerners tend to have a dolichocephalic (long-headed) skull shape. Evolutionarily, due to a more collectivist development, East Asians tend to follow commands more and prioritize the species' standpoint, leading to temporal lobe development and suppression, activating a psychological mechanism to seek pleasure through habits like teeth clenching. This results in more developed zygomatic bones and lateral skull areas. On the other hand, Westerners, due to individualistic development, tend to think more, talk more, and behave more freely, which leads to frontal lobe development and thus more developed forehead regions with less developed zygomas.

To undergo zygoma augmentation surgery, preoperative planning is necessary. Through a 3D CT scan, the facial bone structure, asymmetry, presence of maxillary sinus abnormalities, and zygoma protrusion direction are carefully examined. Using a 3D printer, a customized implant is created to enlarge the zygomatic bone. At this time, care must be taken to ensure that the infraorbital nerve is not compressed when inserting the implant, by leaving a gap to prevent nerve pressure. The implant is inserted above the bone through an incision inside the mouth, thereby making the midface more three-dimensional.

Zygoma augmentation may also be considered due to age-related midface volume loss, or when the zygomatic bone is depressed due to trauma. In such cases, the zygoma can be osteotomized and elevated, and both the frontal and temporal limbs of the zygoma are osteotomized and fixed with titanium.

If the depressed bone is too difficult to elevate through osteotomy, artificial implants can be inserted over the maxilla and zygoma. Especially in trauma-related cases, if the maxillary sinus is fractured and sinusitis is present, inflammation could spread to the implant, so preoperative management and control of rhinitis or sinusitis are required. If one wants to avoid complications like infection from artificial implants, autologous tissue grafts can be used as an alternative. However, since there are size limitations with autologous implants, they may not be suitable for significantly augmenting the zygoma. One method involves grafting the mandibular bone (obtained while slimming the jaw) onto the zygoma. For a more ergonomic bone graft, bone particle grafting can be performed by grinding the bone. However, in the case of bone particle grafts, the absorption rate can exceed 30%, and inflammation may occur in some cases, so the physical condition must be carefully checked before surgery.

Fat grafting is the best way to minimize inflammation risk while using autologous tissue, and can be used as an alternative to elevate the zygoma. If only a slight augmentation is needed, costal cartilage can be harvested and cartilage particle grafting can be partially injected to slightly enhance the zygoma.

Thus, zygoma augmentation can be performed using either artificial or autologous tissue to provide volume to the midface.

[Zygoma augmentation surgery is a cosmetic surgery that enhances the three-dimensional appearance of the midface.]

– 667mm Growing Pine Tree –