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This study aims to evaluate the accuracy of L-shaped reduction malarplasty with bone setback or resection on the zygoma and the mortice and tenon joint structure on the zygomatic arch under the guidance of virtual surgical planning (VSP). Adult patients with zygomatic protrusion or hypertrophy were enrolled and divided. L-shaped reduction malarplasty with or without bone resection and with the mortice and tenon joint structure on the zygomatic arch was conducted either by digital procedures comprising VSP and three-dimensional (3D) printing titanium templates (Group I) or by conventional methods (Group II). Positions of representative landmarks and superimposition models were analyzed by 3D cephalometry. Satisfaction rate and incidences of clinical complications were compared as well. Satisfactory reduction of zygomatic protrusion or hypertrophy was recognized among all 78 patients. Improved symmetry and great surgical accuracy were observed according to the cephalometry analyses. The bone segment movement of virtual plans and actual results in Group I were measured and showed no obvious difference for the inward movement (5.42 ± 0.98 mm vs. 5.33 ± 0.93 mm, P = 0.6906) and the sagittal overlap (4.77 ± 1.32 mm vs. 4.87 ± 1.21 mm, P = 0.7386) at the zygoma roots, along with the step length at the long-arm of the L-shaped osteotomy line (2.43 ± 1.11 mm vs. 2.39 ± 0.89 mm, P = 0.8665). The high resemblance between virtual plans and actual results was depicted via superimposition models. Meanwhile, a higher satisfaction rate (28 in 36, 78% vs. 20 in 42, 48%) and a lower incidence rate of complications (11 in 36, 31% vs. 21 in 42, 50%) were found in Group I. Within the limitations of the study it seems that the application of VSP in reduction malarplasty could significantly contribute to better surgical accuracy and reduced difficulties in the operation, which would be beneficial to patients with zygoma hypertrophy or prominence. [ABSTRACT FROM AUTHOR]

Reduction malarplasty is one of the most popular procedures for esthetic facial contouring in East Asians. The retrospective observational study aimed to analyze the association between the zygomatic change and bone setback or resection to propose quantitative guidance for L -shaped reduction malarplasty based on computed tomographic (CT) images. A retrospective observational study was conducted on patients who underwent L -shaped reduction malarplasty with bone resection (Group I) or without bone resection (Group II). The amount of bone setback and resection was calculated. The unilateral width changes of the anterior, middle, and posterior zygomatic regions as well as zygomatic protrusion change were also evaluated. Pearson correlation analysis and linear regression analysis were used to analyze the relationship between the bone setback or resection and the zygomatic changes. Eighty patients who underwent L -shaped reduction malarplasty were included in this study. Significant correlation was observed between the bone setback or resection and the change of anterior, and middle zygomatic width as well as protrusion in both the two groups (P <.001). The correlation between bone setback or resection and the posterior zygomatic width change was not significant (P ＞.05). The bone setback or resection of L -shaped reduction malarplasty lead to the anterior and middle zygomatic width and zygomatic protrusion changes. Furthermore, the linear regression equation can be referenced as a guidance for a preoperative surgical plan. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare two kinds of reduction malarplasty in terms of their bony consolidation. Patients that underwent reduction malarplasty were reviewed retrospectively. The medial movement of the zygomatic body and the zygomatic arch as well as the complications and satisfaction of patients were investigated. The surgical procedure entailed a classical or modified L-shaped osteotomy through intraoral and sideburn approaches. Two groups were distinguished, those for whom a mortice and tenon joint was formed on the zygomatic arch (Group I), and those that formed end-to-end bone contact (Group II). All the cases in Group I showed an improved facial contour with sufficient bone contact. A larger medial movement of the zygomatic arch was observed in Group I (4.54 ± 0.41 mm) than in Group II (2.72 ± 0.29 mm) (P = 0.016). More bone malunion was observed in six cases of Group II (P = 0.030) and four required a second operation. In conclusion, this study indicates that the mortice and tenon approach is preferable when the priority is bony consolidation. [ABSTRACT FROM AUTHOR]