Reduction malarplasty using sliding setback osteotomy

A prominent malar complex results in a triangular facial shape. When combined with a prominent mandibular angle, the face appear to be aggressive and masculine. Surgical procedures to correct these features are commonly requested by Asian women. Baek introduced reduction malarplasty by underpositioning of the "osteotomized" zygoma. We modified Baek's procedure by sliding the osteotomized zygoma superoposteriorly, The posterior surface is not separated from the soft tissue to preserve the blood supply to the zygoma. Ten patients with prominent zygomas underwent reduction malarplasty from March 1994 through July 1996. Seven patients were female and 3 patients were male. All patients were satisfied with their results. A symmetrical appearance was achieved in all patients. This method provides for precise malar reduction under good exposure. Symmetry of the zygoma is easily achieved. There is no effect on the survival of the malar bone after the procedure because the osteotomized zygoma has its own blood supply on the posterior surface. The masseteric origin is preserved, which ensures minimal cheek drooping after reduction.