On Clinic Facial Contouring Malar-Midface Reduction Surgery: Regaining a Small, Three-Dimensional Face by Correcting Widened Face and Asymmetry After Failed Malar Surgery

One day, a patient visited my office. From the first impression, their face looked generally wide, and their head even seemed larger. As we began the consultation, the patient explained that they had previously undergone malar reduction surgery at another hospital. However, they expressed concerns that after the surgery, their face had become wider and flatter, and their head seemed even larger.

Upon reviewing the patient's CT scans, it was clear that while the 45-degree malar area had been reduced in the previous surgery, this had inadvertently made the posterior and anterior midface areas relatively wider, giving the overall impression of a flatter and larger face. This case demonstrated how significantly reducing only a part of the cheekbone can impact the overall balance of the face.

During the consultation, the patient mentioned hearing from another hospital that reducing the bone around the eyes could make the eyes appear larger. Indeed, some clinics in Japan and Korea advertise cutting the orbital bone (eye bone) to enlarge the eyes. However, this is a fundamentally incorrect method and, in my opinion, a dangerous surgical approach bordering on fraud.

• Counterproductive Effect of Smaller Eyes: Cutting the orbital bone can actually make the eyes appear smaller. Reducing the bones around the eyes doesn't enlarge them; instead, it can weaken the supporting structure, causing the eyes to appear sunken or smaller.
• Facial Proportion Distortion: If only the orbital bone is reduced without considering the overall midface proportions, the lower part of the face may appear wider than the upper part, disrupting facial balance and making the eyes look even smaller.
• Risk of Functional Problems: The orbital bone plays a crucial role in protecting the eyes. Aggressively manipulating this area carries a risk of serious functional problems such as vision impairment and ocular motility disorders.

At On Clinic, we accurately diagnosed the issues from the patient's previous surgery and devised a revision surgery plan that considered the overall harmony of the face. The core objectives of the surgery were as follows:

• Midface Reduction: Effectively reduce the widened midface to narrow the facial width and enhance three-dimensionality.
• Malar Repositioning and Fixation: Reposition the 45-degree malar bone to its correct location and securely fix it to improve the facial contour.
• Facial Asymmetry Correction: Align the severe malar asymmetry on both sides to create a balanced face.

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The surgery was meticulously planned using 3D CT. The angle of the malar bone, which was only half-remaining due to the previous surgery, was readjusted to design a face that appears overall smaller and more three-dimensional.

Upon reviewing the patient's 3D CT scans after surgery, it was evident that the midface had been reduced by more than half, significantly narrowing the facial width. Furthermore, the severe malar asymmetry was perfectly aligned on both sides, showing significant improvement. The malar bones were perfectly fused and remained stable.

After the surgery, the patient looked in the mirror and expressed their satisfaction, exclaiming, "I'm truly beautiful!" They were delighted with their much more three-dimensional and smaller face, and their balanced contour. This was the result of precise surgery that went beyond simply reducing bone, considering the golden ratio and three-dimensionality of the face.

On Clinic deeply understands each patient's face, accurately identifies issues from previous surgeries, and provides optimal solutions. Our mission is not merely to reduce bone, but to restore the overall harmony and beauty of the face.

Dr. Myungjun Oh, On Clinic | Last reviewed 2024-05-23