jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: osteotomy on August 30, 2015, 11:04:42 PM
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I underwent a zygomatic osteotomy. I'm wondering if anyone had the same procedure and has some input. I'm not too long out now so obviously I still have some swelling, however, even with the swelling it is evident I didn't get the amount of projection I hoped for. With swelling going down, I'm ending up with limited projection at the zygomatic arch. Did anyone get a malar osteotomy? Did it give a lot of extra projection? .
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ZO gives no anterior projection, only lateral. Who was your surgeon?
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I was told a zygomatic osteotomy can in fact give both lateral and anterior projection.
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maybe he wasn't aggressive enough with his movements. baldguy on this forum recently got it done and he said he's very pleased with it.
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Well, another big name surgeon who does them a lot told me in no uncertain times that it would give only lateral. Honestly, I don't see how it can be otherwise, maybe it can provide a little bit of tenting at the front, but not much.
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How many mm of movement either/both anterior and lateral did you and your surgeon agree upon, OP?
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Well, another big name surgeon who does them a lot told me in no uncertain times that it would give only lateral. Honestly, I don't see how it can be otherwise, maybe it can provide a little bit of tenting at the front, but not much.
Exactly this. In my case, I only really needed lateral support, so I'm very pleased with the result. The bit of tenting was a nice bonus.
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So what does your surgeon say about this?
Really you cannot expect anterior projection from ZSO except maybe a little at the outer corner of the eye. But if you were significantly recessed there it will not help you.
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Swelling has gone down considerably and so has projection. I still have a lot of swelling after the ZSO, but in areas where I expected to end up with significant projection, there is limited projection even with the swelling.
I'm wondering now how predictable the result of a sandwich osteotomy is; it doesn't seem the golden key to me to get prominent lateral or anterior projection at the malar prominence. I would rather describe it as giving some support. I can't help feeling disappointed about the results thus far.
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When the initial swelling for my ZSO went down, I looked like I had ridiculous cheekbones, I looked like a caricature and was really shocked. It seemed totally overdone. Only over the 6 months after that did it normalize and swell down to the point where I eventually had the desired result that still looked natural. So it seems that if you already feel the movements were not big enough now, then you should discuss the result with your surgeon.
I also do not understand, why you avoid naming your surgeon, especially considering you find your result disappointing.
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Ncharm: Who was your surgeon, if you don't mind my asking?
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When the initial swelling for my ZSO went down, I looked like I had ridiculous cheekbones, I looked like a caricature and was really shocked. It seemed totally overdone. Only over the 6 months after that did it normalize and swell down to the point where I eventually had the desired result that still looked natural. So it seems that if you already feel the movements were not big enough now, then you should discuss the result with your surgeon.
I also do not understand, why you avoid naming your surgeon, especially considering you find your result disappointing.
That I will still lose a significant amount of projection is discouraging to hear.
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Lateral projection, yes, but as 27F said I suspect that the end result will depend a lot on what your bone structure looks like to start with. I have very low set cheekbones and had a very narrow face, so for me the change made me look more feminine, because the ZSO will not magically give me the typical male model high set cheekbones if I don't have that structure to start with. But I am still happy about the result because now my narrow face is improved, and I look more youthful.
So what were your goals and expectations when you had this procedure, I wonder? In any case the swelling really is more than you would expect, even after the initial trauma swelling, there is still much more subtle swelling that only subsides after months. So it is also possible, that your cheekbones will pop out more, when that swelling has subsided.
Breakingbad, my surgeon was Triaca
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If you have a very poorly defined midface to start with, then a ZSO alone won't fix that I think.
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Man I wish I could see some pics of a nice ZO cuz I'm contemplating getting it done after jaw surgery....
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Swelling can be a blessing and a curse. It can make things look really nice but it tricks you, and gives you false expectations. If the swelling is anything like what you get from SG it could take 6-12 months to resolve.
Did you discuss with your surgeon what sort of look you wanted? It could be best to wait 6 months before making a decision, no point in stressing out about it. You need to have a cold calculated outlook to make a good decision.
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Okay I'm taking control of this discussion.
1) First, ZSO: means Zygomatic Sandwich Osteotomy, correct? (who are the docs who do this and who on this board has had it done?)
2) What's ZSSO then: Zygomatic Saggital Split Osteotomy (is this any different? again who are the docs who has had this done)
3) Orbital rim & Zygomatic osteotomy --so far Sinn is the only one we know who does this, who has had it done!!??? Earl only. This is of course A) different from the above in that it takes the orbital rim as well. Can it also position the orbital rim (in my case which is quite low) higher up, so the cheekbones begin higher up as well? It provides upto 8mm projection, we know that, and supposedly earl's upper cheeks and under eye area are fuller. Does this supply all of the benefits of the ZSO as well?
Osteotomy, please indicate who your surgeon was so that we may have a productive discussion and sharing of information here.
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Slightly off-topic but i want an answer to this.
Someone, I think 27f, posted a link of a video of a doc doing fillers straight to the cheekbone. Could you please repost that video please. I found it very instructive and I want to remember what filler that was and who the doctor was. If anyone remembers which thread it was on please repost it here. Thanks chumbawambas.
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yes, zso= zygomatic sandwich osteotomy
Some of the conclusions in this topic pretty much sum it up: the shape of your own cheekbone is going to determine the result of your zso. If you have a poorly defined midface as Baldguy described, you won't end up with strong, high and defined cheekbones. 27F said that well too. If your own cheekbones don't have a sharp angle, you won't end up with angled cheekbones after a zso. Another poster here that had a zso confirmed that too, writing about her experience.
I did discuss in each consult that I was hoping to get prominent angles with strong projection at and laterally from the malar prominence. That it is impossible to get prominent angled cheekbones through a zso when you have poorly defined cheekbones yourself, was not discussed in the consult.
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hmmm you should find out and share here your surgical notes like how many mm projection was achieved etc. and maybe your before and after x-rays too.
What are you gonna do? HA paste or maybe fillers? Fillers seem to achieve results but it looks odd.
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I hope my surgeon will avoid that by doing CAS