Skip to main content
Erschienen in: Aesthetic Plastic Surgery 1/2020

07.11.2019 | Original Article

Application of the Bracing System in Reduction Malarplasty in Asian Population

verfasst von: Guoxuan Dong, Li Teng, Jianjian Lu, Yuanliang Huang

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

In the East, a broad and prominent malar is considered to express an aggressive and unpleasing impression; therefore, patients seek to improve their appearance through malar reduction. Although most of the techniques have been greatly improved, still there are some pitfalls in the form of cheek sagging or bone nonunion. In this study, we performed a reduction malarplasty using a firm bracing system to minimize major postoperative complications.

Method

This was a retrospective study evaluating the results of a total of 157 patients (139 women and 18 men) who underwent reduction malarplasty using a bracing system via intraoral and periauricular. The age of the patients ranged from 17 to 44 with a mean age of 25.3 years. The mean follow-up period was 9.4 months. All patients underwent routine physical and laboratory examinations. Facial photographs in the frontal, oblique, and submentovertical views were taken. Patients with severe facial asymmetry and facial deformities were excluded from the study. Preoperative states and patients’ desires were considered. In some patients, combined malarplasty with mandibular angle reduction or genioplasty was performed.

Results

A total of 157 patients who underwent this modified reduction malarplasty between January 2015 and January 2019 were retrospectively reviewed. Decent postoperative facial stability and satisfactory aesthetic results were realized among all patients. Major complications such as severe asymmetry or bone nonunion were not observed in our patients.

Conclusion

Based on a thorough anatomic understanding of zygoma and masseter action, we modified previous L-shaped reduction malarplasty through constructing a firm bracing system on the malar complex. Satisfactory surgical outcomes were obtained. Our method is an ideal surgical method to effectively reduce the height and width of the zygomatic arch and prevent complications such as bone nonunion and cheek drooping.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Park S, Noh JH (2008) Importance of the chin in lower facial contour: narrowing genioplasty to achieve a feminine and slim lower face. Plast Reconstr Surg 122:261–268CrossRef Park S, Noh JH (2008) Importance of the chin in lower facial contour: narrowing genioplasty to achieve a feminine and slim lower face. Plast Reconstr Surg 122:261–268CrossRef
2.
Zurück zum Zitat Le TT, Farkas LG, Ngim RC et al (2002) Proportionality in Asian and North American Caucasian faces using neoclassical facial canons as criteria. Aesthet Plast Surg 26:64–69CrossRef Le TT, Farkas LG, Ngim RC et al (2002) Proportionality in Asian and North American Caucasian faces using neoclassical facial canons as criteria. Aesthet Plast Surg 26:64–69CrossRef
3.
Zurück zum Zitat Onizuka T, Watanabe K, Takasu K, Keyama A (1983) Reduction malarplasty. Aesthet Plast Surg 7:121–125CrossRef Onizuka T, Watanabe K, Takasu K, Keyama A (1983) Reduction malarplasty. Aesthet Plast Surg 7:121–125CrossRef
4.
Zurück zum Zitat Kim YH, Seul JH (2000) Reduction malarplasty through an intraoral incision: a new method. Plast Reconstr Surg 106:1514CrossRef Kim YH, Seul JH (2000) Reduction malarplasty through an intraoral incision: a new method. Plast Reconstr Surg 106:1514CrossRef
5.
Zurück zum Zitat Yang DB, Chung JY (2004) Infracture technique for reduction malarplasty with a short preauricular incision. Plast Reconstr Surg 113:1253–1263CrossRef Yang DB, Chung JY (2004) Infracture technique for reduction malarplasty with a short preauricular incision. Plast Reconstr Surg 113:1253–1263CrossRef
6.
Zurück zum Zitat Chen CT, Pan CH, Liao HT et al (2016) Combined intraoral and endoscopic approach for malar reduction. Aesthet Surg J 36(10):sjw081CrossRef Chen CT, Pan CH, Liao HT et al (2016) Combined intraoral and endoscopic approach for malar reduction. Aesthet Surg J 36(10):sjw081CrossRef
7.
Zurück zum Zitat Yang X, Mu X, Yu Z et al (2009) Compared study of Asian reduction malarplasty: wedge-section osteotomy versus conventional procedures. J Craniofac Surg 20:1856–1861CrossRef Yang X, Mu X, Yu Z et al (2009) Compared study of Asian reduction malarplasty: wedge-section osteotomy versus conventional procedures. J Craniofac Surg 20:1856–1861CrossRef
8.
Zurück zum Zitat Nakanishi Y, Nagasao T, Shimizu Y et al (2012) The boomerang osteotomy—a new method of reduction malarplasty. J Plast Reconstr Aesthet Surg 65(5):e111CrossRef Nakanishi Y, Nagasao T, Shimizu Y et al (2012) The boomerang osteotomy—a new method of reduction malarplasty. J Plast Reconstr Aesthet Surg 65(5):e111CrossRef
9.
Zurück zum Zitat Yang HW, Hong JJ, Koo YT (2017) Reduction malarplasty that uses malar setback without resection of malar body strip. Aesthet Plast Surg 41:910–918CrossRef Yang HW, Hong JJ, Koo YT (2017) Reduction malarplasty that uses malar setback without resection of malar body strip. Aesthet Plast Surg 41:910–918CrossRef
10.
Zurück zum Zitat Lee SW, Jeong YW, Myung Y (2017) Revision surgery for zygoma reduction: causes, indications, solutions, and results from a 5-year review of 341 cases. Aesthet Plast Surg 41(1):161–170CrossRef Lee SW, Jeong YW, Myung Y (2017) Revision surgery for zygoma reduction: causes, indications, solutions, and results from a 5-year review of 341 cases. Aesthet Plast Surg 41(1):161–170CrossRef
11.
Zurück zum Zitat Chen T, Hsu Y, Li J et al (2011) Correction of zygoma and zygomatic arch protrusion in East Asian individuals. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 112(3):307–314CrossRef Chen T, Hsu Y, Li J et al (2011) Correction of zygoma and zygomatic arch protrusion in East Asian individuals. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 112(3):307–314CrossRef
12.
Zurück zum Zitat Wang T, Gui L, Tang X et al (2009) Reduction malarplasty with a new L-shaped osteotomy through an intraoral approach: retrospective study of 418 cases. Plast Reconstr Surg 124:1245–1253CrossRef Wang T, Gui L, Tang X et al (2009) Reduction malarplasty with a new L-shaped osteotomy through an intraoral approach: retrospective study of 418 cases. Plast Reconstr Surg 124:1245–1253CrossRef
13.
Zurück zum Zitat Jang H, Lee S, Jung G (2010) Reduction malarplasty with small preauricular incision. Plast Reconstr Surg 126:186e–188eCrossRef Jang H, Lee S, Jung G (2010) Reduction malarplasty with small preauricular incision. Plast Reconstr Surg 126:186e–188eCrossRef
14.
Zurück zum Zitat Baek R-M, Lee SW (2009) Face lift with reposition malarplasty. Plast Reconstr Surg 123:701–708CrossRef Baek R-M, Lee SW (2009) Face lift with reposition malarplasty. Plast Reconstr Surg 123:701–708CrossRef
15.
Zurück zum Zitat Lu J, Xu J, Zhang C (2018) Double support technique in malar reduction surgery. J Chi Plast Surg 34(1):20–23 Lu J, Xu J, Zhang C (2018) Double support technique in malar reduction surgery. J Chi Plast Surg 34(1):20–23
16.
Zurück zum Zitat Park JT, Lee JG, Won SY et al (2013) Realization of mastmatory movement by 3-dimensional simulation of the temporoman & bularjomt and the masttcatory muscles. J Crantofac Surg 24(4):e347–e351CrossRef Park JT, Lee JG, Won SY et al (2013) Realization of mastmatory movement by 3-dimensional simulation of the temporoman & bularjomt and the masttcatory muscles. J Crantofac Surg 24(4):e347–e351CrossRef
17.
Zurück zum Zitat Song WC, Choi HG, Kim SH et al (2009) Topographic anatomy of the zygomatic arch and temporal fossa: a cadaveric study. J Plast Reconstr Aesthet Surg 62:1375–1378CrossRef Song WC, Choi HG, Kim SH et al (2009) Topographic anatomy of the zygomatic arch and temporal fossa: a cadaveric study. J Plast Reconstr Aesthet Surg 62:1375–1378CrossRef
18.
Zurück zum Zitat Myung Y, Kwon H, Lee SW et al (2017) Postoperative complications associated with reduction malarplasty via intraoral approach: a meta analysis. Ann Plast Surg 78:371–378CrossRef Myung Y, Kwon H, Lee SW et al (2017) Postoperative complications associated with reduction malarplasty via intraoral approach: a meta analysis. Ann Plast Surg 78:371–378CrossRef
19.
Zurück zum Zitat Yang L (2017) Clinical study and biomechanical evaluation of reduction malarplasty with the bracing structure. Peking Union Medical School, Beijing Yang L (2017) Clinical study and biomechanical evaluation of reduction malarplasty with the bracing structure. Peking Union Medical School, Beijing
20.
Zurück zum Zitat Lin L-X, Yuan J-L, Wang Y-T et al (2015) A new infracture technique for reduction malarplasty with an L-shaped osteotomy line. Med Sci Monit 21:1949–1954CrossRef Lin L-X, Yuan J-L, Wang Y-T et al (2015) A new infracture technique for reduction malarplasty with an L-shaped osteotomy line. Med Sci Monit 21:1949–1954CrossRef
21.
Zurück zum Zitat Lee YH, Lee SW (2009) Zygomatic nonunion after reduction malarplasty. J Craniofac Surg 20:849–852CrossRef Lee YH, Lee SW (2009) Zygomatic nonunion after reduction malarplasty. J Craniofac Surg 20:849–852CrossRef
22.
Zurück zum Zitat Bayram B, Araz K, Uckan S et al (2009) Comparison of fixation stability of resorbable versus titanium plate and screws in mandibular angle fractures. J Oral Maxillofac Surg 67:1644–1648CrossRef Bayram B, Araz K, Uckan S et al (2009) Comparison of fixation stability of resorbable versus titanium plate and screws in mandibular angle fractures. J Oral Maxillofac Surg 67:1644–1648CrossRef
Metadaten
Titel
Application of the Bracing System in Reduction Malarplasty in Asian Population
verfasst von
Guoxuan Dong
Li Teng
Jianjian Lu
Yuanliang Huang
Publikationsdatum
07.11.2019
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2020
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01532-0

Weitere Artikel der Ausgabe 1/2020

Aesthetic Plastic Surgery 1/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.