Zygoma Revision: A Dramatic Change in a Patient with Complete Bone Non-Union
I met a patient in my office who was still stressed about her facial proportions despite having undergone two previous cheekbone Surgeries. The patient felt that her face looked large every time she wore a hat, and this went beyond cosmetic concerns, affecting her daily life.
Problems with Previous Cheekbone Surgery: Diagnosis of 'Non-Union'
The moment I checked the patient's CT scan, I was shocked. Her cheekbones were completely separated, like 'chalk.' A clear black line was visible between the bones, indicating that the bones had not united at all. Usually, non-union refers to cases where the bones are partially unattached, but in this patient, the bones were completely separated, making the term non-union seem almost inadequate. Even the posterior part of the cheekbone was not attached.
Surprisingly, the patient did not experience any bone movement or functional discomfort. However, cosmetically, a step deformity was visible on her face, which caused her significant stress. It was determined that the bones were not properly fixed in the previous Surgery, or even if they were, the bones did not unite. Furthermore, the lengths of both mid-faces were different, at 24mm and 20mm, indicating severe facial asymmetry.
O.N Clinic's Revision Surgery Goal: Perfect Union and Proportion Improvement
I promised the patient that I would reattach more than 90% of these completely separated bones. My Surgery prioritizes ensuring that the bones unite firmly. In the CT scan taken after the Surgery, we could confirm that the cheekbones were perfectly attached. As the bones completely united, the black line visible before the Surgery disappeared, and the improvement was so natural that no line was visible.
The cheekbones that were next to the nose before the Surgery have now moved next to the eyes, shortening the length of both mid-faces to 10mm, and making the overall facial proportions much more harmonious. The patient mentioned that her mouth corners seemed slightly lifted after the Surgery, which suggests a positive change in the tension of the facial muscles as the bone position improved.
Post-Surgery Care and Misconceptions about Lifting
After Surgery, the process of the skin adhering closely to the bone as swelling subsides is important. I explained to the patient that we would begin 1:1 customized Lifting management for skin contraction starting from the one-month mark. At this time, many patients consider a facelift, but after cheekbone Surgery, a facelift may be unnecessary or even detrimental.
A facelift involves pulling up the skin near the ears, but the skin around the cheekbones is pulled less, which can make skin sagging appear worse than before the Surgery. Additionally, for 1-2 years after Surgery, sagging may not be very noticeable due to residual swelling, but when the swelling completely subsides, the skin may appear more stretched, often leading to the misconception of 'do I need another facelift?' Therefore, after cheekbone Surgery, customized Lifting management that helps the skin adhere well to the bone and promotes collagen production is important.
Through this revision cheekbone Surgery, the patient achieved satisfactory results with perfect bone union and improved facial proportions. I am also very happy to have helped the patient regain natural beauty and confidence in her face.
O.N Clinic | Last reviewed 2026-05-23