As a female I'm not at all happy with the zygomatic osteotomy either. But I had cheek implants before I had the osteotomy. The implants gave me those high chiseled cheekbones you are talking about. And surgery and recovery were a breeze. I was out days after surgery looking a bit puffy still, but nothing weird. Whereas I was looking like a car crash victim for a good 4 weeks after the zygomatic osteotomy and very swollen long thereafter. If I look back at pictures I can see my face was still a lot bigger months after the osteotomy than it currently is. And I was thinking it was the end result back then (eeuh: not).
The implants gave projection over the malar prominence, laterally too, and part of the orbital rim. Whatever suits your needs however, since they can be placed wherever you need projection. And I often got complimented about my cheekbones. Now, on the other hand, I get the opposite (a friend kind of in awe with his own bone structure and unaware of my surgery, joked I could get some of his cheekbones. After such costly surgery to get cheekbones that sucks).
I had the implants removed because of worries about erosion and infection. People that write on this forum say they worry about that. The surgeon that only performed osteotomies (and didn't use implants) told me the same: that it could be a concern. Yet surgeons that perform both osteotomies and implants said they did not experience it, recommended implants since the outcome would be better, and were willing to give me the contact information of patients that had had implants for many years. Add that I never found anyone with an infection of the cheek implants or erosion of the cheeks on the internet. Frankly I feel I've let doom thinking influence my decision.
I've seen several male patients of Dr. Yaremchuk with the model type high chiseled cheekbones. But he doesn't have those pictures on his website. I've seen a girl that had surgery to her cheeks with him that got into modelling thereafter. She also had the high cheekbones.
Also: a new era in medicine has started. You can get implants now and if you are really that worried, 5-8 years from now there will be enough possibilities to get them replaced with bone implants. It won't be a big deal, you can just get the implants out and the bone implants in if you are so worried. Without going through the looooooooooong recovery of the osteotomy now.
Not to mention that with the kind of osteotomy you want to try to convince any surgeon to do now, you will be at more risk for nerve damage. There is a reason the zygomatic osteotomy is performed as it is often performed, away from the orbit. As my surgeon put it: he found there was way too much risk of nerve damage to cut closer to the orbit. You will be convincing a surgeon to do something he out of practice and knowledge about the risks does not commonly do that way now. You can make any cut in that picture in whatever direction you wish, but that doesn't mean it can be executed in surgery without major risks, if at all possible. And it also doesn't mean that the results will look as you imagine: you might have to rotate the bone, or break it in smaller parts and augment it a bit more here than there, to get those high cheeks you want. It ain't gonna happen exactly as you wish simply by putting the bone outwards.
I'm seeing if I can still get implants over the high part of the zygomatic arch again to get back those high cheekbones. But all in all this pretty much sucks and it must be difficult to get it right now, with the projection I got low on the cheek.
