The Procedure

What is the procedure?

All women wish to have the beautiful face and looks symmetry. But unfortunately, in some peoples were born with the imperfect face appearance, especially in Asian peoples with the big cheek bone make the face look strong, not gently. Because the cheekbone is the focus points of the middle face which normally, the man will have the level of cheekbone higher than the woman and obviously visible. This is the reason that the mostly of the people who have this face character is seeking for the way to correct this kind of flaw on the face. And cosmetic surgery or we know as Cheekbone reduction procedure (Zygomatic reduction)is the best way to reduce the volume of the cheek to make the people have a smaller face, shallow face and smoother, smarter impression.

But for the prior thing peoples who would seeking to do this procedure, should ask yourself the reason why you would like to do because you don’t happy with the size of your cheek bone or need to improves another part of your face which may needs another procedure , not cheek bone reduction. So, it’s quite importance to learn all things about the procedure before undergo the surgery and select to have a surgery with the specialist in the standard hospital only. Because after you undergo for the surgery can you don’t satisfied with the result of the surgery. It’s quite complicated for the revision because this is the surgery about contouring the bone. Then, if some parts of bones are removed, can’t take it back.

And even Cheekbone reduction is a major surgery which looks complicated procedure to reduce the width of face in order to make the face smaller and more feminine. Due to the surgeon need to reshape your real bone, and should scary. But actually, it’s not that horrendous as the peoples imagine about. The surgeon wills reconstruction the structures of your face become more natural curve balance and be symmetry and balance comparing to the forehead and chin. And the result of this is permanent and very natural looking. This procedure can be performed in combination with the other facial contouring such as Jaw Line reduction to make an oval shaped facial appearance ( V shape).

The Method

How the procedure is performed?

 

The procedure will be performed under general Anastasia to make the patient sleep during the surgery with 2 techniques

1. Adjusting the Zygomatic bone

This is the common method of cheekbone reduction procedure which is easy to perform and less risky and complications. The procedure will start with marking on your cheekbone, the area need to be removed. And the surgeon will make an incision in your upper mouth and insert the device to contour the cheek bone and begin to reshape the cheek bone from outside your mouth. The both ends of cheekbone (the small piece) will be cut which is not bigger than 0.5 cm. Otherwise,the sinus cavity will be accessed and not too safe for the patients. And the incision will be closed in the final process.This technique is suitable for the peoples who have not too high cheekbone because this method, the surgeon can contour your cheekbone very less which doesn’t effects too much to the middle zone of the face.

2. Removing the position of Zygomatic bone

The procedure will be started with marking on your cheekbone, the area where they need to be removed. And the incision will be made in front of the ear canal and across to another side (and sometimes, can make an incision in the mouth also but more risky) to separate out the cheekbone, the eye hole bone and upper jaw line. Some part of the zygoma is reduced either by shaving or cutting the involved bony segment (zygoma) and then moved it inward, backward and downward in the skull. Then, when the zygoma is repositioned, they will be secured and attached by the special metal titanium or in the general name is mini plate or screw. And then, the incision will be closed with the suture.

What type of Anastasia is necessary for the procedure?

General Anastasia

How will the incision look like?

If the incision is placed inside your mouth (for the patients with not too high volume of the cheekbone), the incision will be invisible. But if you have outside incision, the stab incision will be appeared at the front of your ears, a 3 mm of the length and is concealed in hair and sideburn, it is noticeable.

Ideal Candidates

Is this procedure suitable for the candidate?

  • The candidate for cheek bone reduction can be both of man and woman, but must be in good health, no serious medical problems which can’t undergo the major surgery
  • Over than 18 years old , when the body is stopped developing 
  • The people with very high volume or very wide of the cheekbone and want to reshape it 
  • The peoples who don’t happy with the asymmetry and the unbalance of the face especially on the upper part of the face which come with the birth
  • The woman with the face looks very strong like man because of the high level of cheekbone 
  • For the woman, the structure of the face looks very strong like the man because of the high level of cheekbone 
  • The transgender who want to correct the face structure to become more feminine appearance to be ready to undergo another procedures for sex changing
  • The people who have the conspicuous side and front zygoma bone(cheekbone)
  • The peoples who wish to have a slender facial line(V shape)
  • The people who want to increase the self-confident and look softer 
  • The people who have the normal face structure, be confirmed by the surgeon that you can undergo cheekbone reduction 
  • The people who are confirmed by the surgeon that the cause of making your cheek looks wide are because of the bone, not the fat tissue. Otherwise, you are not a candidate for cheekbone reduction 
  • The people with the stable mentality, be patient to wait for the final result of the surgery which may need to take a several months. Otherwise, you can get depresses during this time 

What are the results the candidate can expect?

  • The result of the surgery is immediately visible and permanent 
  • The face structure is improved to be more symmetry and balanced
  • The cheek looks more natural curvy beautiful
  • Your face will appear to be narrower than before and including the volume of prominent cheekbones is reduced, your face look more rounded straight contour to the face
  • The face look more feminized, both in the real woman and transgender 
  • The upper part of your face looks smaller, symmetry and looks 

Recover/Post-Operative

Length of stay at the hospital and in Thailand

2 nights stay in the hospital, recommends 12 days in Thailand

Pre-operative care

  • Before the surgery can happen, you need to have a consultation with the surgeon and inform them all information about your medical problem, your allergies, medical you are taking
  • You should tell the surgeon about the expected result of your surgery to see that it’s realistic to do or not, measure the width and the length and any corners of the facial bone including planning the surgery method 
  • The surgeon also needs to inspect your facial bone and the soft tissues by X-ray or Radiological assessment (Facial X-rays or CT scans) ad also check the cause of high volume of the cheek , it’s because of the bone or fat tissue
  • Be sure that you understand the surgery clearly, which technique of the surgery the surgeon will perform with you, the complication, the incision and etc.
  • You will be asked to stop taking Aspirin, ibuprofen, and products containing aspirin and ibuprofen may inhibit blood clotting and cause bleeding problems during and after surgery including anti-inflammatory medication and including high dosing any multivitamins/herbal remedies/teas etc. that contain high levels of Vitamin E, Ginseng, Ginko and fish oils before and after the surgery for 2 weeks because there can thin your blood
  • Stop smoking and drinking all kinds of alcohol before and after the surgery for 2 weeks also, this’s effect to delay wound healing after the surgery
  • You should drink a lot of water because of the surgery, you may feel very thirty

On the surgery date

  • Stop eating and drinking before the surgery 6 hours 
  • Take a bath and wash your hair wash your hair and clean inside your ears with the cotton bud. But do not apply the lotion and cream on the body including no makeup
  • Take out all accessories, such as earring and also remove the nail polish before getting the operation room
  • Wear the loose cloths or comfortable, If possible take the shirt with the button in front
  • Sleep well before the surgery
  • Make a physical checking up to be sure that you have the normal level of your blood pressure or any disease come up which can’t undergo the surgery or not

Post-operative care

  • After the surgery, you may feel difficult to open the mouth, but it’ because of the swelling and will go away over the time 
  • If you feel pain, the painkiller pill and antibiotics medication is recommended if the pain is extremely and for preventing to get infection during the healing process and continue taking them until they are all gone
  • The surgeon will recommend you lay down in the position with your head higher than body. This will help relieve pressure from your treatment area reducing swelling and pain
  • The surgeon will recommend applying the cool pack or frozen peas, this can reduce the swelling and stop bleeding (especially, the first few days is recommended to keep cool pack on your surgery area all the time) and including vitamin A and C is also can help
  • You may be recommended to use the compression garment to support the surgery area (your cheek)
  • During the recovery time, try to drink water as much as you can 
  • Stop eating after the surgery date at least 24 hours to avoid getting infection from the bacteria in the mouth and keep eating the soft food until 2 weeks after the surgery and continue avoiding strong food or sticky food or the uncooked foods, fresh fruits or vegetable which maybe have the bacteria contained until 4 weeks Because this is risky to make your incision get infection
  • Try to drink water as much as you can but in the contrary hand, oral antibiotics and analgesics are recommended to do as often as you can 
  • Keep all incision and suture lines free of moisture to ensure proper healing, do not allow creams, lotions, or topical arnica into the incision because they can cause inflammation
  • You may notice a change in your smile, tingling, the sporadic sharp pain, pulling, burning, cold or other unusual sensations. These usually subside within the first few weeks. Your end result is usually seen within 4 months
  • Don’t try to touch the incision and the wound with your tongue because it can make the incision separate from each other
  • About 7 days after the surgery, you have to come back to see the surgeon again for follow up checking to be sure that the incision go well, no side-effect or complication
  • You can resume light activity the day of surgery. Do not lifting heavy objects and, especially, no bending over to lift objects. Its can caused of raising your blood pressure and heart rate through strenuous which this can slow-down the healing process 
  • Avoid extreme activities or strenuous sport at least 3 weeks because of the rising high blood. This can cause of bleeding inside your cheek
  • Healing the wound after the suture is removed can be enhanced using micro-pore tape, moisturizing creams, massage, vitamin E, steroid injections, and silicone sheeting
  • You can start walking again after the surgery as much as you can to avoid the blood clots but do not make the extreme exercise which can disturb your incision such as running or any activities that you have to put your head up and down which and be effect to the blood pressure but the extreme activities or strenuous sport should avoid at least 3 weeks because of the rising high blood

What are the possible risks and complications involved?

Normal symptoms

After the surgery, you may feel pain, bruising, numbness, swollen around the cheek. But it’s just for temporary and will fade away over the time.

Infection 

Normally, the surgeon will let you take the oral-antibiotic both of before and after the surgery to prevent getting the injection from the operation. But due to if you have the incision inside your mouth, it will be more risky to get injection comparing to the incision outside the mouth in case you don’t clean your incision well after eating anything which is good place for bacteria to grow up. So, keep your mouth clean, gargle your mouth as often as you can. Or if you have an incision outside the mouth (front of your ears). You also should keep it clean, use the sterile water to clean and change the gauze over the incision as often as you can. And you can notice that you may get infection from having the fever after the surgery, or the paid and swollen which should go away over the time increasing. Then, you should go back to see the surgeon again.

Bleeding

It’s very common if you have the blood (also oozing) come out from the incision or the wound in the first few days after the surgery. But if you have a serious bleeding and non-stop, this may be able to cause of another reason which is not normal symptoms after the surgery. So, what you have to do is going back to see your surgeon again as soon as you can. They will make an examination on you and heal you in the right way.

Asymmetry

The both side of the cheek are not balance, this can be cause of the surgeon’s operation (the surge removed the different amount of the cheek bone from 2 sides ) .Injury to the surrounding nerves, blood vessels, muscles or bones. Or maybe the original structure of your face is not asymmetry. So, when the surgeon operated the surgery from both side of the cheekbone can give the different result. But this is rare because before the surgery, the surgeon will make an x-ray on the structure of your face, not only face to face consultation.

Injury to the surrounding nerves, blood vessels, muscles or bones

For cheekbone reduction, the facial nerve which controls your brow runs from a point just in front of your ear, over the zygoma bone to innervate the muscles which control your brow. It can be damaged anywhere along that pathway during surgery. And the surgeons will try to avoid this problem by don’t contour the facial bone along the pathway of the nerve. But this problem is normally occurring in temporary time, only the first few weeks after the surgery. But if it’s long last and don’t fade away over the time, you much go to see your surgeon and let see your concern area.

Changes in the skin sensation over the cheek (temporary)

You may feel numbness on your cheek for a while, and feel pain when you try to open the mouth, but try to keep healing yourself as the normal what you are suggested by the surgeon. And this symptom will fade away over the time.