Had a zygomatic osteotomy ... lack of projection

[osteotomy]

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? .

[PloskoPlus]

ZO gives no anterior projection, only lateral. Who was your surgeon?

[osteotomy]

 I was told a zygomatic osteotomy can in fact give both lateral and anterior projection.

[terry947]

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.

[PloskoPlus]

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.

[meepmeepmeep]

How many mm of movement either/both anterior and lateral did you and your surgeon agree upon, OP?

[baldguy83]

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.

[ncharm]

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.

[osteotomy]

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.

[ncharm]

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.

[Breakingbad]

Ncharm: Who was your surgeon, if you don't mind my asking?

[osteotomy]

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.

[ncharm]

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

[baldguy83]

If you have a very poorly defined midface to start with, then a ZSO alone won't fix that I think.

[terry947]

Man I wish I could see some pics of a nice ZO cuz I'm contemplating getting it done after jaw surgery....