This patient had previously undergone cheekbone reduction surgery at another clinic but visited On Clinic due to several post-operative issues. When I first reviewed the 3D CT images, I was quite surprised. The patient presented with the following problems:
- Over 10 fixation pins were embedded in the cheekbones
- Wide gaps were observed between the bones (bone gaps)
- Increased difficulty for revision surgery due to pins located too close to the eye area
Furthermore, the pins positioned too close to the eye area were a major factor increasing the difficulty of revision surgery.
Why is Cheekbone Revision Surgery Difficult?
Cheekbone revision surgery goes beyond simply re-shaping the bone. The key is to accurately identify and resolve the problems that arose from the previous surgery. In this patient's case, the excessive use of fixation pins and the wide bone gaps hindered bone fusion and caused asymmetry. More pins do not necessarily lead to better results. On the contrary, unnecessary pins can increase the risk of inflammation or nerve damage and impede the natural healing of the bone. Especially for pins located too close to the eyes, a very cautious approach was required during removal to avoid damaging critical structures like the optic nerve.
On Clinic's Precise Diagnosis and Customized Plan
The patient's face had severe left-right asymmetry, and her jaw was also slightly misaligned. While periorbital asymmetry or jaw misalignment are difficult to improve with cheekbone surgery alone, I determined that the asymmetry of the cheekbones themselves was fully correctable. We meticulously analyzed the patient's bone structure, the location of existing pins, and the extent of bone gaps using 3D CT. Based on this, we formulated a customized surgical plan to achieve maximum fixation with the minimum number of pins, simultaneously resolving asymmetry and ideally adjusting the midface length.
Fixation Pin Removal and Bone Gap Improvement
The most urgent task was the safe removal of the 20 existing fixation pins. Pins located very close to the eyes, in particular, demanded extreme concentration and delicate surgical skill. After successfully removing all pins, the widened bone gaps were precisely aligned to promote fusion. To address the issue of bone gaps despite the previous use of many pins, we used only 4 essential pins to securely fix the bone. This choice was made to ensure bone stability while minimizing unnecessary foreign body sensation.
Asymmetry Correction and Midface Reduction
The patient's left and right cheekbone lengths were distinctly different, and her midface length was also on the longer side. Through surgery, we adjusted the length of both cheekbones to be nearly straight, effectively improving the severe left-right asymmetry. Additionally, the elongated midface area was reduced by more than one-third and lifted upwards, achieving an overall shorter and more youthful facial appearance. The distinctly different left and right cheekbone lines, when viewed from below, also transformed into a balanced look after surgery. By addressing these complex issues, the patient achieved a highly satisfactory outcome.
"In this patient's case, the surgery was difficult because of the challenging pin removal. There were 20 left and right fixation pins located too close to the eyes. There were over 10 pins, more than 10. And they were so close to the eyes, it was really hard to remove them." — Dr. Myungjun Oh
The surgery was a very challenging process, but through precise diagnosis and skilled techniques, all problems were successfully resolved. The patient was highly satisfied with the noticeably improved facial contour and resolution of asymmetry after the surgery. Cheekbone revision surgery is much more complex and difficult than the initial surgery, so it is crucial to entrust it to medical professionals with extensive experience and expertise. On Clinic is committed to accurately diagnosing each patient's condition and providing safe and effective solutions.
Dr. Myungjun Oh, On Clinic | Last reviewed 2026-05-23