Camouflaging the Posterior Zygomatic Arch Protrusion After Zygoma Reduction Surgery

Zygoma reduction is a very common procedure for Asian patients. Usually, the procedure is undertaken in such a way that the zygomaticotemporal suture area is fractured in and pushed medially. In carrying out this procedure, dissection is avoided within approximately 1 cm posterior to the zygomatic arch, due to the possible impairment of the temporomandibular joint space during osteotomy, especially cases where the posterior portion of the zygoma protrudes further than the frontal and middle portions. Since protrusion of the posterior portion of the zygomatic arch is not reduced with the operation, the transverse facial width of the cheek will remain unchanged, and thus there is a high possibility for a remaining step deformity at the osteotomized part of zygomaticotemporal suture. This has been discussed as a limitation of zygoma reduction surgery. We believe in reducing the transverse width of the face even in these cases by covering the protruding area of the posterior zygomatic arch through a single hair graft method. This method was used in 16 outpatient procedures between 2009 and 2011. All patients presented with postoperative arch protrusions that remained after initial zygomatic reduction at other clinics. All of these patients were women, and their average age was 29.4 years. The patients presented for correction an average of 3.4 years after initial surgery. Only patients who had protrusion of the posterior zygomatic arch—documented through clinical photos and palpation—were treated with this technique.