Q: Dr. Epsy, cheekbone reduction osteotomies will help make the ears more visible and get a concave, especially the lower part of the cheekbones. I also have infraorbital implants. Is it possible to do cheekbone osteotomies without damaging the infraorbital implants?

A: Your application for cheekbone reduction osteotomies is unique to give your previous cheekbone osteotomies. In essence, you are really trying to return the closer cheekbones that you once had. While bone change can be achieved, I don’t think they make their ears more visible. It would be likely to have some impact, I am creating a slight increase in concavity in the cheek area, but this would be quite limited given the thickness of their soft tissues that trust.

With respect to their existing infraorbital implants, I do not know exactly where they are, since they are not evident in the 3-D computerized tomography. (See attached) I suspect that they would be safe from the bone bone reduction osteotomy of the cheek, since they are unlikely to get in the bone step you have in your cheekbones.

Here’s a detailed informative response for the topic “Will Cheekbone Reduction Osteotomies Damage My Infraorbital Implants? – Plastic Surgeon”:

Will Cheekbone Reduction Osteotomies Damage My Infraorbital Implants? – A Plastic Surgeon Explains

Cheekbone reduction osteotomies (commonly referred to as zygoma reduction) are popular procedures for reshaping and narrowing the face, particularly in individuals seeking a more refined, V-line contour. However, for patients who already have infraorbital implants (implants placed beneath the lower eyelid to enhance midface projection), a crucial question arises:

Could cheekbone reduction surgery compromise the integrity or positioning of these implants?

Let’s explore this in depth.

Understanding Cheekbone Reduction Osteotomies

Cheekbone reduction involves cutting and repositioning the zygomatic bone (the cheekbone) to create a narrower facial width and softer contours. This is typically done through intraoral or coronal incisions, and the osteotomy lines are carefully planned to preserve surrounding anatomical structures. The repositioned bone segments are then secured with plates or screws.

Location of Infraorbital Implants

Infraorbital implants are typically placed over the infraorbital rim, beneath the lower eyelid and adjacent to the orbital floor. They are positioned anterior to the zygomaticomaxillary complex (the upper cheekbone structure), but their placement is relatively superficial compared to the deeper cuts made during a cheekbone reduction osteotomy.

Potential Interactions and Risks

Here’s what a board-certified plastic surgeon would consider:

•  Proximity of Surgical Sites:
  The zygoma reduction osteotomy is usually performed laterally on the zygomatic arch and body, while infraorbital implants are positioned medially and superiorly. Although these areas are relatively close anatomically, a careful and experienced surgeon can perform the osteotomy without disrupting the infraorbital implant.
•  Implant Integrity:
  If the infraorbital implant is well-integrated and securely placed, it is unlikely to shift or be damaged by the osteotomy cuts, as long as the cuts do not extend excessively medially or superiorly. However, excessive force during bone mobilization, inadequate surgical planning, or unexpected anatomical variations could increase risk.
•  Surgical Approach:
  If a surgeon is aware of the existing implants, they can modify their approach, possibly using a more lateral osteotomy line or applying gentler mobilization techniques to avoid implant disruption.
•  Scar Tissue and Healing:
  Pre-existing scar tissue from the infraorbital implant surgery might alter tissue planes, but a skilled surgeon can account for this during planning. However, healing may be slightly less predictable due to prior surgical intervention.

Key Takeaways

Infraorbital implants are typically not in the direct path of cheekbone reduction osteotomies, especially when the procedure is meticulously planned.
An experienced plastic surgeon will evaluate CT scans and preoperative imaging to identify the precise locations of implants and bone cuts.
Pre-existing implants should always be disclosed during consultation, as they may necessitate a customized surgical plan.
The risk of implant damage is low, but not zero—especially if the surgeon is not familiar with your specific anatomy and implant positioning.

Final Thoughts

If you’re considering cheekbone reduction surgery and have existing infraorbital implants, it’s essential to:
🔹 Choose a board-certified facial plastic or maxillofacial surgeon with experience in both procedures.
🔹 Discuss your full surgical history, including implant type, placement, and date.
🔹 Request a preoperative imaging review (such as 3D CT scans) to map out precise anatomy.
🔹 Consider a custom surgical plan to minimize risks.

With careful planning and expert execution, it is possible to achieve beautiful facial contouring without compromising your infraorbital implants.