Consideration of operative procedures for zygomatic reduction in Orientals: based on a consecutive series of 28 clinical cases.

Operative procedures for reduction malar bone plasty were considered in our consecutive series of 28 Japanese cases. The patients consisted of 7 males and 21 females whose ages ranged from 21 to 57 years. The operative procedures used were either shaving the protruded zygomatic body and arch with chisels by means of an intraoral approach and/or an extraoral sideburn-lateral canthal approach or, alternatively, mobilizing the protruded zygoma en bloc medioposteriorly into reduction of the prominent zygoma by a coronal approach. In principle, the noncoronal approach was indicated for males and young females, and the coronal approach, conducted in association with forehead lifting with or without canthopexy, was indicated for females over age 40. These procedures have individual merits and demerits. In some cases, associated surgery was performed concomitantly according to the facial balance or facial rejuvenization. We believe that the optimal operative approach and operative procedure should be considered in accordance with the patient's sex, age, wishes, and/or cultural background.