A New Double Trapezoid-Shaped Osteotomy for Reduction Malarplasty.

Background: Various surgical techniques have been introduced and developed for the reduction of wide zygomatic bone. However, the previous methods have several disadvantages, including the following: potential cheek droop, a limited amount of possible volume reduction, an unfavorable contour due to nonunion, and limited inward repositioning of the zygomatic arch. Thus, the authors introduce an effective method to overcome the limitations and disadvantages of other previous reduction malarplasty techniques. Methods: From March of 2010 to May of 2014, 532 women and 152 men underwent reduction malarplasty using a double trapezoid-shaped osteotomy. This method was created by making both 1 trapezoid-shaped osteotomy line that consisted of 2 oblique and 1 transverse line in the frontal view, and a second trapezoid-shaped osteotomy line, which consisted of 2 oblique osteotomies made to be slightly broader in the cross-sectional view. Results: Reduction malarplasty with double trapezoid-shaped osteotomy was successfully performed in all patients. No severe complications were observed. There were some minor complications. In most patients, a wide midface with prominent malar eminences was reshaped into a slender contour. Conclusions: A double trapezoid-shaped osteotomy for reduction malarplasty might be a more effective method to overcome the limitations of other previous techniques. The prominent malar eminences can be reduced effectively without major complications, and moreover, the cheek area can be induced to have an upward lifting and a 3-dimensional convexity of the midface.