Indent from possible zygoma fracture - Treat with surgery or fillers? (photo)

Question

I was unfortunately assaulted around a week ago. At the time there was bruising and swelling, now the swelling is going and i can see that an indent is forming, the area is still very tender to touch. The attached picture doesnt quite show how bad the indent is. What would be the best way forward to treat this, surgery or fillers? Many thanks

Phileemon Eric Payne, MD · Answer

Without being able examine you, it is difficult to determine if this is a fracture or some other sort of injury. Typically with fractures, it is important to obtain a CT Face scan to view the bones for fractures. When the zygoma is fractured, people typically experience difficulty with opening and closing the jaw since there are muscles that run under the bone and can get pinched or attach to the zygoma bone itself. 
Fillers should not be used in cases of facial fractures because it does not fix the problem and will only be temporary. Reducing the fracture to realign the bones so they can heal is the most important step with facial fractures. The zygoma can easily be reduced with a small incision either in the hair or better, inside the mouth. Once the bone is reduced, it will take about 8 weeks to fully heal and most people will need a soft diet while the bones heal. Difficulty with opening or closing the mouth or jaw will be treated in addition to any visible deformities seen on the face. 
I recommend going to a board certified surgeon who specializes in oral maxillofacial trauma or a craniofacial surgeon who can help you. You should obtain a CT Face scan as soon as possible to determine if there is a fracture. 
Eric Payne, MD

Mark Domanski, MD · Answer

Sorry to hear about your assault.  First of all, many states and counties have a crime victims fund that can help cover medical and other expenses.  Make sure you seek this out.
Second, zygoma fractures are typically treated with an incision in the hairline and the zygoma bone is pushed out to its previous location.  However, zygoma fractures are often associated with other facial fractures so a CT scan of the face may be prudent.  Patients I operate on typically go home the same day after this type of surgery.
If the fractures has already healed, the sequela may be camouflaged by a filler or a facial implant.  If a filler is chosen, and the patient likes it, fat grafting can be used down the line to obtain a more permanent result.
Of course, these are my general thoughts about zygoma fractures.  Specific recommendations for a given patient would require an inpatient evaluation.

Indent from possible zygoma fracture - Treat with surgery or fillers? (photo)

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Indent from possible zygoma fracture - Treat with surgery or fillers? (photo)

Answers (2)

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Everything you need to know about Facial Reconstructive Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.