Cheekbone Reduction
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The width of the middle third of the face is mainly determined by the height of the cheekbones and zygomatic arches. The height of the cheekbones has a close relationship with the proportions of other parts of the face, such as the width of the mandible, the width of the temporal bone in the temple area, and the development of the temporalis muscle. Additionally, whether the cheekbones are prominently protruding also relates to the amount of subcutaneous fat; if the subcutaneous fat is too little and the person is clearly underweight, it may make the cheekbones and zygomatic arches appear more prominent. Therefore, the height of the cheekbones and zygomatic arches is actually a relative concept, and there are currently no clear boundaries or diagnostic standards.
However, in daily life and clinical practice, we can visually distinguish between prominent and less prominent cheekbones and zygomatic arches. Thus, high cheekbones can be divided into "true" high cheekbones and "false" high cheekbones. If most people believe that this person has an enlarged cheekbone body, and the zygomatic arch is indeed high and affects aesthetics, then it can be diagnosed as "true" high cheekbones. This type of facial structure is commonly seen in people from Guangdong and Guangxi provinces in China. People with high cheekbones often have bilateral asymmetry, and sometimes they also exhibit bilateral asymmetry in the development of the mandible, but this still falls within the normal range. This phenomenon is due to differences in bilateral development during individual growth and is not caused by pathological conditions. If one side of the cheekbone or zygomatic arch develops excessively large, resulting in obvious bilateral asymmetry, then pathological changes should be suspected, such as fibrous dysplasia or other possible tumors. In the case of "false" high cheekbones, the patient themselves may feel their cheekbones are high, or for professional reasons, such as models and actors who need to look good on camera, while in reality, their cheekbones do not appear particularly high. This can be diagnosed as "false" high cheekbones.
From the perspective of Chinese aesthetic values: It is generally believed that slightly lower cheekbones in the middle third of a woman's face look better, while a narrower and smaller jawline, especially at the mandibular angle, and a slightly pointed chin forming what is known as a "peach-shaped face," appears more delicate.
Preoperative Preparation:
The purpose of the surgery is primarily to remove the enlarged cheekbone or zygomatic arch.
Before the operation, it is necessary to first clarify whether the enlargement of the cheekbone is due to physiological normality or pathological abnormality. If it is pathological bone proliferation or a tumor, further systematic comprehensive examinations and possibly combined surgical treatments are required. If it is simply dissatisfaction with the benign shape of the cheekbone or zygomatic arch, then part of the cheekbone and zygomatic arch can be removed through surgery. Preoperatively, the degree, range, and extent of the zygomatic arch's prominence should be clarified and measured to estimate the range and amount to be removed.
Surgical Conditions:
1. Before the operation, it must be confirmed that there are no diseases in important organs such as the heart, liver, spleen, lungs, and kidneys.
2. Routine tests such as blood, urine, chest X-rays, and electrocardiograms should be normal.
3. Avoid menstruation (for females) during the surgery.
Surgical Methods and Precautions:
Design and length of the surgical incision:
There are four types of incisions: the lower eyelid incision (the length of the lower eyelid), the oral approach incision (about 2 cm), the preauricular incision (located between the normal skin in front of the ear and the hairline at the temples, about 2-2.5 cm long), and the coronal incision within the hairline (a transverse incision between the ears within the hairline).
Lower Eyelid Incision: Advantages: Close to the surgical area, the scar is not very noticeable in the long term. Disadvantages: The incision is relatively small, the exposure of the surgical area is insufficient, the osteotomy range is limited, and post-surgery, there may be a period where the lower eyelid appears lax due to surgical traction. Currently, this approach is used less frequently.