Reduction Malarplasty without External Incision: A Simple Technique

Background: The concept of Eastern facial beauty is different from that of the Western. Prominent malar bones are perceived as unattractive by Easterners, including the Thai. Many techniques for malar reduction, such as chiseling or burring of the zygomatic body, are ineffective in reducing facial width. At present, the concept of medial movement of the zygomatic body is accepted as the treatment of choice. However, all current approaches leave some external facial scars, usually at the preauricular area. Objective: A new, effective, and simple technique for reduction malarplasty that leaves no external scars is described here by the authors. Method: The technique consists of a purely intraoral approach to remove a segment of anterior zygomatic body, to create a greenstick fracture at each zygomatic arch, and to medially mobile the zygomatic body, which is then fixed by wiring at the end. Results: All eight patients who underwent this surgical procedure have satisfactory results without complications after one to six years of follow-up. Conclusion: This technique represents another step of improvement in cosmetic craniofacial surgery to reduce both anterior and lateral projections of the malar eminences for better facial harmony.