Prominence is the defining characteristic of an aesthetically appealing set of cheekbones; vertical projection makes little difference unless the lack of it is accompanied by recession. High cheekbones are always prominent to a degree, but only low cheekbones can be either prominent or recessed. Angelina Jolie, Johnny Depp, and many other aesthetically appealing celebrities have low-prominent cheekbones for example.
That being said, there are no modern procedures that can fix recessed cheekbones, except in certain cases. Conventional cosmetic surgeries that address the zygomas such as implants and filler are hindered by their inability to change the shape of the infraorbital rim and move the origins of the skeletal muscles, which the implants or filler instead surround or avoid altogether.
The osteotomies are capable of moving the origins of the skeletal muscles, but none of them are universal solutions: Lefort III can only be applied to patients with class III malocclusions, Zygomatic Sandwich osteotomies can only increase lateral projection, and Lateral Swing osteotomies can only increase forward projection.
If a procedure existed that could fix recessed cheekbones, it would have to be capable of changing the shape of the zygomaxillary complex and the section of the maxilla lateral to the nasal cavity so that there is adequate forward and lateral projection. It would also need to provide new origins for the skeletal muscles. There are two ways I can image this being done, and both options are highly dangerous, and likely impossible considering the medical limitations we currently have:
- Replacing the zygomaxillary complex entirely with 3D printed bone scaffold. But how are you to preserve the infraorbital nerve and transfer the origins of the skeletal muscles onto the scaffold?
- A combination of the Zygomatic Sandwich osteotomy and the Lateral Swing osteotomy. But what would happen to the infraorbital nerve?
Any thoughts, criticisms or contributions? Are there any new procedures that I should know about? There’s a lot of knowledgeable people on this board, and I’d love to be educated further on the subject
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