Reconstruction for malar asymmetry.

Congenital and posttraumatic deformities may cause facial asymmetry of the malar area. Onlay grafting and/or craniofacial repositioning techniques are most frequently used in repair. There are various indications for, as well as limitations of, both onlay grafting techniques and craniofacial repositioning. Measurements of the deformity make more accurate corrections possible. Anthropometric data obtained from skulls confirm that a simple geometric formula can be developed for prediction of the final result after the rotation-advancement of the depressed malar eminence. The surgical technique has evolved through the care of six recent patients. The method places emphasis on the three-dimensional nature of the repair and the requirements in craniofacial repositioning for stable fixation with bone-to-bone contact.