Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of midface deficiency. Reports concerns regarding flat malar contour, infraorbital hollowing, and lack of anterior projection. Denotes no history of facial trauma or prior orthognathic surgery. Aesthetic goals include enhancement of zygomatic prominence and improved facial harmony.
Clinical Examination Findings
Physical examination reveals bilateral malar hypoplasia with flattened zygomatic eminence. Palpation confirms deficient bony support in the infraorbital and malar regions. Assessment of soft tissue envelope shows adequate skin elasticity. No evidence of cranial nerve deficit or malocclusion. Midface projection measured via lateral cephalometric analysis confirms skeletal retrusion.
Treatment Protocol
Proposed treatment plan involves surgical augmentation of the malar region. Options discussed include: 1) Custom-fabricated or pre-formed alloplastic implants (e.g., porous polyethylene) via intraoral or subciliary approach. 2) Autologous fat grafting for volume restoration. 3) Zygomatic osteotomy for skeletal advancement in severe cases. Risks, benefits, and potential complications including implant displacement or asymmetry explained in detail.