Zygomatic Arch Osteotomy

[Optimistic]

Am I right in thinking that a ZAO is very seldomly performed and perhaps a risky procedure to undergo?

I've been paying a lot of attention to the way people's faces are invariably smaller on the left side than the right, and it occured to me how simple it would be to achieve greater symmetry. Essentially the skull portion is irrelevant given that hair covers it. Likewise the forehead is not of concern. This leaves just two points which define one side of the face's width - the jaw angle and the zygomas.

Jaw angles can be improved, and asymmetries resolved with the likes of a chin wing.

Therefore, would a surgeon ever perform a kind of zygomatic arch-come-malar osteotomy with the stated goal of improving facial symmetry and width in a non-syndrome patient? I feel like a lot of people could benefit from this.

Alternatively, are there less invasive options such as grafting along the arch?



Leave your thoughts and feelings, friends 

[sean89]

I've been paying a lot of attention to the way people's faces are invariably smaller on the left side than the right

Is this true? The left side of my face is less defined (has less brow bossing) and my left gonial angle is steeper.

With chin wing, you have the option of symmetrising the gonial angles, but you will probably choose to make them both as square as they can possibly be. Because the left gonial angle was steeper to start off with, you will probably not be able to make it as square as the right gonial angle.

My right gonial angle was good, my left gonial angle was bad. After chin wing, my right gonial angle was very good, my left gonial angle was good, but they weren't symmetrical but I don't regret that.

[geijutsu]

Are there doctors in europe or US who perform this? So far, the only doctors I've seen performing it are in south Korea where they only distract the zygomatic arch to reduce overly wide cheekbones in Asian women.

[MrFox]

I've been paying a lot of attention to the way people's faces are invariably smaller on the left side than the right, and it occured to me how simple it would be to achieve greater symmetry.

What I've never noticed this?
Maybe the cause is people sleeping exclusively on their left side whilst growing up.

If you don't find any western surgeons that would carry this out then I'm sure as the arch osteotomy used for reduction is so prevalent in South Korea, there would be someone willing to do the reverse there.

[Rico]

crucial motor nerves in this area. surgeon must be careful.

I'm also looking for someone skilled in this area.. but in Europe

[Optimistic]

What I've never noticed this?
Maybe the cause is people sleeping exclusively on their left side whilst growing up.

If you don't find any western surgeons that would carry this out then I'm sure as the arch osteotomy used for reduction is so prevalent in South Korea, there would be someone willing to do the reverse there.

I believe the reason is that the face forms in the womb on the right side first, then left. Thus symmetry is a sign of good development or something. Anyway, take a face and cut it in half with photoshop. Then put two left sides and two right sides together. You'd be surprised how alien people look when its just their left side being morphed into a single face 

[PloskoPlus]

Symmetry is overrated.

[Rico]

Symmetry is overrated.

right. I never had ideal symmetry. I never used to think about that.... now only because of old  fracture
and for me is strange trying to get ideal symmetry

rather no max-fac surgeron needed but therapist

[Optimistic]

Symmetry is overrated.

I think it all depends where one lies within a range of acceptable deviation from the norm

[Lazlo]

why are there never pictures of this?

[PloskoPlus]

why are there never pictures of this?

Very good question.

[falcao]

why are there never pictures of this?

There are few reasons I can think of:
1. It's not often done, as there is an easier way for cosmetic surgeons - implants. Cosmetic surgeons rarely work with bone, except in the case of rhinoplasties. They work with implants, soft tissue (facelifts etc), fillers.
2. When it is done, it is maxillofacial surgeons who do it. Maxillofacial surgeons do not typically post before and afters on their websites. In fact, the vast majority of them, including some of the very best ones, do not have a website at all, although we are in 2014.
3. It is not often done in US as far as I know, in fact I don't know if it is performed there at all (maybe with rare exceptions). Most countries in the world preclude doctors from posting pictures of their patients online for advertising purposes (certainly the case with Germany and Switzerland, where we know it is performed). 

[Lazlo]

i don't think we should be discussing this unless we actually figure out who is doing it and that it can actually benefit us --i.e. good before and after pics.