Intraoral approach for reduction malarplasty: a simple method.

Young Korean women with prominent zygoma may experience stress in daily life because the Oriental physiognomy often associates prominent zygoma with bad luck. Moreover, prominent zygoma in a wide Oriental face has the effect of making a person appear older and stubborn. Zygomatic reduction is often necessary to relieve stress from self-consciousness about facial appearance and to obtain younger and softer features. As such, most zygomatic procedures are cosmetic; therefore, an entirely intraoral approach with no skin incision is desirable. The current operative method of zygomatic reduction consists of two steps. The zygomatic body and arch are exposed through a mucoperiosteal incision from the maxillary canine to the first molar area. The first step is to grind and file the zygomatic body. The second step is made on the zygomatic arch. Using an oscillating saw, a partial-thickness osteotomy is made just posterior to the orbital rim, and a full-thickness osteotomy is made just anterior to the articular tubercle of the zygomatic arch. Light pressure on the posterior part of the arch produces a greenstick fracture of the anterior osteotomy site and a complete fracture of the posterior osteotomy site, resulting in inward repositioning of the zygomatic arch. This method of zygomatic reduction is simple, easy, effective, and leaves no conspicuous scars on the face.