I had a zygoma bone broken 3 years ago. It has been left spun under and in on the arch and part of my eye socket at about 5 millimitres. Is this something that can be corrected? I'm interesred in my own bone not an implant and I hate the way it look. Thank you.
Can Broken Zygoma Bone Be Fixed?
Doctor Answers (14)
Zygomatic Osteotomy for Secondary Correction of Old Fracture
Zygomatic fractures rotate down and inward resulting in a cheek deficiency and an orbital lowering if left unrepaired. Depending upon the extent of the bone displacement, the zygomatic complex can be re-fractured (osteotomized) and reposiitoned back to its pre-injury position long after the bone has healed. This is done through an intraoral and lower eyelid incisions. Based on how much zygomatic movement needs to be done, a bone graft may also be needed.
Revision Facial Fracture Surgery
As someone who has done probably more facial fracture than anyone else in northern VA I can tell you of course it can be fixed. Correcting facial fractures that were either not repaired initially or were repaired poorly are difficult to repair but definitely not impossible.
The surgery involves cutting the bone at the previous fracture site, reducing or realigning the bone and plating the "new" fracture. It definitely is not as easy as fixing an acute fracture but the results will be the same.
Late repair of zygoma fracture.
Cheek bone fractures can be difficult to repair. The difficulty of this type of repair certainly increases as time goes on due to scarring of the bone. Like skin, bone forms a scar over the injury site to naturally stabilize the fracture.
Since it has been three years since the fracture occurred, scarring is the rule. There are many approaches to access the fracture through the eyelid, inside of the mouth, or scalp. Once exposed the healed fracture would likely need to be re-fractured. This will allow for manipulation of your cheek bone. Additional fractures (osteotomies) of the cheek bone may be necessary to allow for maximal re-positioning and outcome following your surgery. Plates and screws ( metal and/or resorbable) are used to fixate the fracture to prevent dislocation of the bones while healing.
If implants are needed and you are not interested in alloplastic (synthetic material) implants, bone grafts from the skull or hip bone can be used. You should remember that obtaining bone grafts will add to the post-operatively healing period.
In some cases, the orbit (eye socket) may need manipulation to maximize the aesthetic result.
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Late repair of a zygoma
Late repair of a zygoma is difficult but doable. It depends on your aesthetic and functional deficit. Cheek contour defects can often be repaired by implants or grafting of rib bone to the surface of the zygoma/orbital rim, or with osteotomies (rebreaking). For associated orbital fractures causing sinking of the eye, orbital implants are used to reform the contour of the eye socket.
Repair of mal united zygoma
A Photograph of your face would have been helpful to determine the deformity. Although it it may difficult and challenging with proper maxillofacial reconstructive surgical tecnique a satiffactory correction is possible .Calvarial split grafts(thin sheets of your own skull bone) is the ideal material if you prefer your own tissue. Cadaveric bone paste combined with GEM21 growth factor matrix may also be used as graft matatrial. You also need to get 3D Ct Scan of your face for pre operative evaluation. Good luck .
A broken facial bone that has "healed" into a poor position can be difficult to fix. Options are as follows:
- Use of facial fillers to balance facial asymmetry
- Use of alloplastic implants to balance facial asymmetry
- Formal osteotomies are re-plating of fracture
Old zygoma fractures are tough to fix
When the zygoma breaks, it alters a few critical facial structures that effect cheek projection, eyeball position and facial width. Fixing an old zygoma fracture (or one that was repaired incorrectly the first time around) can be difficult. You've got two options- if your eyeball position is okay, then your cheek projection and facial width can be restored with bone grafts or an alloplastic implant. The other option is to osteotomize the zygoma and rotate it back into position and fixate it with plates and screws.
Facial bone malpostion can be fixed without implants
We see many patients with old facial injuries. I have recently corrected several old deformities that have failed correction with injections, and facial implants. I use a technique that involves your own rib cartilage and other tissues in your body.
Delayed Zygoma Repair Is Difficult Use Cheek Implant instead or Filler
It is very difficult to repair a zygoma bone after it is healed in a new position. You have to address the question;
what is it that you are trying to accomplish?
If you just want a prominent cheek bone then use a filler or a cheek or zygoma implant. It is a lot less risky than trying to fix an old zygoma fracture.
If it is only a zygomatic arch fracture then may be it can be fixed. However, if the orbit is involved it can be dangerous as moving the bones and breaking them can cause a bleed inside the orbit and jeopardize your vision. Proceed with caution.
Fixing an old cheek bone fracture
Correcting a previously displace zygoma can be difficult. It would have to be broken again in a process called osteotomies to bring the bone back out. This can create a lot of swelling and nerve weakness which are significant risks of the procedure. A better alternative is an implant placed through the mouth. Other alternatives that I have found that work well to correct the cosmetic disparity if there is no functional component include injections of Sculptra which is an excellent volumizing injectable filler that I have seen last three years or more in post-traumatic facial defects. It can be safely done by injections and relies on your body's own collagen to fill in the depressions. I hope this information helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.