Simultaneous Surgery for Contouring the Prominent Zygoma and Mandibular Angles With Facelift in Middle-Aged Patients

BACKGROUND: As the pursuit of higher self-attractiveness grows, an increasing number of middle-aged people are unsatisfied with their facial contour and required osteotomy. However, for these patients, performing osteotomy only would accelerate the aging process. Herein, the authors put forward simultaneous surgery for contouring the prominent zygoma and mandible with facelift for elderly patients. METHODS: Patients were divided into 3 groups: group A with prominent mandible, group B with protruding zygoma, and group C with prominent mandible and zygoma. By implementing intraoral incision, outer cortex grinding, mandibular angle curved osteotomy, and reduction malarplasty were performed. Through facelift incision, the zygomatic arch was reduced and facelift was conducted. Patients were followed up for at least 12 months and were asked to evaluate their experience. RESULTS: From March 2009 to January 2018, a total of 55 patients received the surgery: 17 patients received mandibular angle osteotomy and facelift, 22 received malarplasty and facelift, and 16 underwent mandible and zygoma contouring and facelift. The recovery process was uneventful, with only 2 patients in group A and 1 patient in group C who suffered from a hematoma, which relieved without surgical intervene. The postoperative images showed smoother facial contours. Patients were satisfied with surgical outcomes. Significant improvements were seen comparing pre- and postoperative photos. CONCLUSION: Conducting osteotomy and rhytidectomy concurrently results in smooth facial contour and youthful appearance which improves patients' self-image and contributes to high patients' satisfaction. With a low complication rate and no long-term complication, the surgery is safe to perform. LEVEL OF EVIDENCE: Level IV, the case study.