Postoperative Complications Associated With Reduction Malarplasty via Intraoral Approach

Abstract

According to our meta-analysis of previous literatures, the aggregated rates of various complications related to reduction malarplasty were not high. Among the various complications, short-term sensory weakness was shown as the most frequent complication, emphasizing the necessity of patient warning and education before and after the operation. Moreover, soft tissue drooping and bone nonunion are also not rare and surgeons should be aware of these complications.

Early Assessment of Computer-Assisted Malarplasty: A Novel Methodology for Both Reduction and Augmentation

“…The advantages of this technique in comparison to the conventional technique include a more precise and finer cutting, and more precise localization of adjacent structures, such as the orbital floor, nerves, etc which reduces the possibility of potential damages. Reported complications with other techniques, such as transient sensory weakness, drooping, nonunion, asymmetry, mouth opening restriction, uncontrolled bleeding, and facial nerve injury, 9 were not noted with our technique, probably because of improved visibility and control during the surgical procedure due to precise cutting. Preoperative and postoperative views of 2 patients who underwent surgery using the malarplasty technique are shown in Figures 4-7.…”

Novel treatment of revision malarplasty with piezosurgery

“…With the increasing popularity and vigorous advances in malar reduction surgery in Asian countries, the number of cases requiring revisional malarplasty after zygomatic surgery has also been on the increase. [ 3 – 5 ] The most common reasons for revisional malarplasty are facial soft tissue loosening, bone nonunion, and asymmetry, which have incidence rates of 2.8%, 2.2%, and 1.8%, respectively. [ 3 , 4 , 6 , 7 ] In particular, bone nonunion can lead to zygomatic block displacement, damage to facial expression, facial droop, and depression.…”

“…[ 3 – 5 ] The most common reasons for revisional malarplasty are facial soft tissue loosening, bone nonunion, and asymmetry, which have incidence rates of 2.8%, 2.2%, and 1.8%, respectively. [ 3 , 4 , 6 , 7 ] In particular, bone nonunion can lead to zygomatic block displacement, damage to facial expression, facial droop, and depression. Nonunion can eventually lead to an increase in the size of the bone suture as a result of gradual absorption of the free broken ends on both osteotomy sides (due to the absence of stress stimulation), and this can make revision procedures more difficult.…”

“…Nonunion can eventually lead to an increase in the size of the bone suture as a result of gradual absorption of the free broken ends on both osteotomy sides (due to the absence of stress stimulation), and this can make revision procedures more difficult. [ 3 , 8 ] However, revision surgery after malarplasty is limited by the narrow intraoperative visual field and scar adhesion in the zygomatic bone area, which make it difficult to accurately control electric osteotomy tools and increase the risk of injury to blood vessels, nerves, soft tissue. In addition, deviation of the osteotomy line is highly likely, and repeated osteotomy could cause thermal damage to the bone and increase bone resorption, thus resulting in failure of the bone defect repair.…”

“…Additionally, plastic surgeons typically use a chisel to cut the bone directly according to the original osteotomy line in order to avoid bone resorption caused by drilling near the crack, but this technique is associated with a high risk of fractures and bone fragmentation. [ 3 , 4 ] Thus, the conventional methods for revision surgery have several drawbacks and risks.…”