Cheekbone Revision Surgery: The Step Deformity and Its Solutions

Cheekbone revision surgery is a complex procedure that goes beyond simply reducing bone size, requiring consideration of overall facial harmony and function. Specifically, 'step deformities' or bone non-union resulting from previous surgeries can cause significant stress and aesthetic dissatisfaction for patients. At On Clinic, we meticulously diagnose these issues and strive to provide optimal solutions tailored to each patient's condition, aiming for satisfactory outcomes.

The patient who visited us recently had undergone previous cheekbone surgery but was concerned about a noticeable indentation on the right cheekbone area. Many people believe these indentations are due to bone gaps or non-union, but there can actually be other causes.

A thorough analysis of the patient's CT scan results revealed that the primary cause of the indentation was not a bone gap. Instead, a portion of the cheekbone located near the sideburns was excessively protruding, leading to a 'step deformity' where the cheekbone appeared divided into two layers, like a staircase. This step deformity created a shadow, making it visually appear as an indentation.

This phenomenon can occur during the osteotomy and repositioning of the bone during surgery, and it is a common issue when the focus is solely on reducing bone size. Especially in male patients, who tend to have larger heads and more developed muscles than females, the difficulty of the surgery is known to be higher. This is why a precise understanding of the bone's anatomical structure and surrounding tissue characteristics, along with a delicate approach, is essential.

At On Clinic, we adopted the following approach to resolve this step deformity:

• Precise Diagnosis: We accurately identify the bone structure and issues through 3D CT scans. In the patient's case, not only was a bone step deformity confirmed, but also areas with insufficient bone.
• Customized Surgical Plan: We focused on smoothly connecting the two layers of the cheekbone into one and sufficiently reducing it inwards to gently improve the facial contour.
• Concurrent Bone Grafting: For areas with insufficient bone, we supplemented volume through bone grafting, creating a natural and robust overall contour. Bone grafting is a crucial process not just for filling in shape, but for long-term stability and natural results.

After the surgery, the patient touched their cheekbone area and exclaimed, 'It's gone!', expressing satisfaction that the indentation had disappeared. Pre- and post-operative CT images confirmed that the midface was effectively reduced and the facial contour became smoother.

Post-operative care is as crucial as a successful surgery for cheekbone revision. At On Clinic, we provide meticulous guidance to ensure patients achieve optimal recovery.

• Swelling Management: Post-operative swelling is a natural phenomenon, but it can be minimized through cold compresses and appropriate compression care.
• Dietary Adjustments: It is advisable to consume soft foods and avoid irritating foods.
• Skin Treatment Linkage: Skin treatments such as Sofwave or Ulthera, which the patient inquired about, are possible approximately one month after surgery. However, the timing of the procedure may vary depending on individual recovery speed and skin condition. I will personally assess the patient's condition and design the treatment, which will then be performed at the dermatology department.

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On Clinic prioritizes patient safety and satisfaction above all else. Based on extensive clinical experience and continuous research, we strive to provide the most suitable solutions for each individual's face. Especially for highly complex surgeries like cheekbone revision, the surgeon's expertise and accurate diagnosis are paramount. We promise to do our utmost to ensure patients maintain satisfactory results for a long time after surgery.

Dr. Myungjun Oh, On Clinic | Last reviewed 2026-05-23