Strategic Approach for Effective Reduction Malarplasty: Depending on Malar Protrusion Type.

[BACKGROUND] Reduction malarplasty is a widely performed facial contouring procedure, particularly in Asian populations, to achieve a slimmer and more oval facial shape. While various surgical techniques exist, there is a lack of standardized guidelines for tailoring the procedure to different zygomatic morphologies. This study aims to establish a strategic classification-based approach to optimize reduction malarplasty outcomes.

[PATIENTS AND METHODS] A total of 3997 patients underwent a reduction malarplasty over a 3-year period. Patients were classified into 3 distinct zygomatic types based on clinical and radiological assessments. The surgical technique was customized for each type, incorporating variations in ostectomy, rotation, setback of the zygomatic body, and medial impaction of the zygomatic arch.

[RESULTS] The classification-based approach allowed for precise modifications in osteotomy techniques, resulting in improved contouring and patient satisfaction. The beveled osteotomy of the zygomatic arch facilitated enhanced bone healing, reduced palpability, and minimized anterior malar depression. In addition, high L-osteotomy and orbital rim shaving were utilized in cases with a prominent inferolateral orbital rim to optimize outcomes.

[CONCLUSIONS] By categorizing patients into distinct zygomatic types, this study presents a systematic surgical approach that enhances precision and predictability in reduction malarplasty. These findings highlight the importance of individualized surgical planning to achieve optimal aesthetic outcomes and patient satisfaction. Further studies with long-term follow-up are needed to refine these techniques.