Malar Bone Revision Surgery: Addressing Bone Gaps and Safety Concerns
The patient we are introducing today visited On Clinic due to severe side effects after their initial malar bone surgery. The previous surgery reportedly lasted an astonishing 11 hours, so long that even family members worried if something had gone wrong. The patient's CT scan unfortunately revealed that there was almost no bone remaining in the left malar area. The bone, thinned to about the width of two finger joints, presented a situation that could lead to severe functional problems.
Problems with Improper Malar Reduction
Many people desire to reduce their facial width through malar reduction surgery. However, indiscriminately shaving off a large amount of malar bone is not always the best solution. Especially for individuals with a large skull, simply reducing more than half of the malar bone often does not significantly decrease the overall facial width. This was also the case for our patient. While the right malar bone was relatively fine, the left malar bone was excessively resected, creating a bone gap of 15mm, which led to facial asymmetry and functional instability.
"There's almost no bone left. The right malar bone is okay, but the left one is truly as thin as a finger joint... Even if you resect more than half of the malar bone, for people with large skulls, this area won't shrink. Indiscriminate malar reduction should not be performed."
Even after the previous surgery, the patient still felt their head was large and wide. There was even a phenomenon where their eyes appeared sunken. This clearly illustrates the limitations of simple reduction surgery that does not consider the position and structural issues of the malar bone. A fundamental approach was needed to reposition the malar bone and make it narrower than the skull.
On Clinic's Malar Reconstruction and Bone Graft Solution
This patient's malar revision surgery demanded a very high level of difficulty due to the severe damage and deficiency of the existing bone. However, at On Clinic, we made our utmost effort to improve the patient's condition.
- Bone Graft Procedure: To fill the 15mm bone gap caused by the previous surgery, we performed a bone graft using bone that was to be removed. This not only fills the gap but also plays a crucial role in securing the structural stability of the malar bone.
- Malar Bone Repositioning and Reconstruction: The small and thinned malar bone was moved inward and reconstructed to align with the eye bone line. Through this process, we were able to improve the overall facial proportions and create a more three-dimensional facial contour.
- Bone Reinforcement: Through bone grafting and reconstruction, the malar bone area, which was barely attached before surgery, was made much stronger and safer. This is an essential process for long-term stability and functional recovery.
After the surgery, the patient's facial proportions were three-dimensionally improved, and they also achieved the effect of bone reinforcement. This success was not due to simple reduction, but rather a delicate reconstructive surgery that considered the anatomical structure of the malar bone and the overall balance of the face. At On Clinic, we meticulously analyze each patient's condition and continuously research and strive to provide the most suitable solutions. Even for challenging revision surgery cases, we will not give up and will do our best to ensure our patients' satisfaction.
Dr. Myungjun Oh, On Clinic | Last reviewed 2024-05-23