Date: March 2025.
Source: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, https://doi.org/10.1016/j.bjps.2025.03.051.
Objective: Reduction malarplasty (RM) is a commonly performed facial skeleton contouring aesthetic procedure in East Asia. However, there is a lack of data on the post-operative changes of facial soft tissue as well as patient-reported outcomes. This retrospective study aimed to evaluate the soft tissue changes and surgical outcomes after L-shaped RM.
Materials and Methods: In this study, 55 patients underwent L-shaped RM were enrolled and 55 patients who underwent genioplasty were also enrolled as controls. The soft tissue changes in relation to the underlying skeletal tissue were analyzed using computed tomography (CT) and three-dimensional (3D) stereophotogrammetry images. The patient’s pre- and post-operative satisfaction as well as surgical outcomes were investigated by the FACE-Q and Wrinkle Severity Rating Scale (WSRS).
Results: In RM group, the soft tissue in zygoma region (S2), zygomatic arch region (S3) and upper cheek region (S5) showed a significant inward reduction postoperatively (p<0.001). Conversely, the paranasal region (S4) showed a significant outward augmentation (p<0.001). Compared with the control group, the postoperative soft tissue changes in S2, S3, S4, and S5 regions demonstrated significant differences in RM group (p<0.001). In the postoperative changes of skeletal tissue, the upper zygoma region (B2), zygomatic arch region (B3) and lower zygoma region (B5) exhibited a significant decrease (p<0.001). Significant correlation was observed between the soft tissue changes and hard tissue changes in B2, B3 and B5 regions (p<0.001). Additionally, patients demonstrated a significant postoperative improvement in satisfaction with appearance, although 6 patients’ WSRS grade increased by one-grade postoperatively.
Conclusions: Following RM, an inward depression of the soft tissue was observed in the surgical regions, while the soft tissue of the paranasal region protruded outward, indicating that the soft tissue exhibited a certain degree of sagging. Furthermore, although the severity of nasolabial folds increased in some patients, the patient’s self-evaluation of aesthetics remained unaffected. The findings suggest that surgeons should consider both skeletal and soft tissue changes when planning RM procedures, and patients should also be informed about potential postoperative soft tissue changes to effectively manage their expectations.
Article: Three-dimensional facial soft-tissue changes after L-shaped Reduction Malarplasty: A pilot retrospective study.
Authors: Xiaoshuang Sun, Yiyuan Wei, Hamza Younis, Zihang Zhou, Han Ge, Jihua Li. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.