What would you recommend to fix my face atrophy and drooping right cheek? (Photos)

Question

About 10 months ago I was hit in the right side (when viewing the picture it’s the left side) of my face with a baseball fracturing my zygomatic arch in multiple places and orbital floor. They used 5 plates to reset my cheekbone and another to repair the floor. As you can see from the side angle I lost some of my cheekbone definition. Is this causing the atrophy or is it the aftermath of the swelling? How can I restore some of the symmetry I lost?

Jason D. Bloom, MD, FACS · Answer

The cheek/midface asymmetry can be multifactorial.  Many people have mild asymmetries at baseline and one side may have been a little more atrophied at baseline.  On top of that, you had a significant trauma to your cheek, zygoma and orbit (ZMC fracture).  They did a good job trying to restore your malar projection as much as possible, but this can definitely exacerbate the problem.  Now the question is what can you do to improve things.  The easiest non-surgical way to improve this is to use strong midface volumizing fillers like Restylane Lyft, Voluma or Radiesse in this area to rebuild the cheek and midface projection.  These should last about a year and help you determine if you see an improvement.  Ultimately, a malar implant can be placed surgically for a permanent fix.Hope that helps!

Zoran Potparic, MD · Answer

It is very frequent that patient develops cheek and periorbital soft tissue atrophy after injury and surgery you had. The best way to address that problem is to replace it with patient own tissue by means of fat grafts; other options would be soft tissue fillers (Voluma, Sculptra, etc.). In person evaluation would help. Good luck.

Carlos Gonzalez Legarda, MD · Answer

I had treated some cases with dermofat graft (not just fat) and other with silicone implants.Just rememeber you looks fine, and normal, but if you wish a procedure, you can gain some of symmetry, but never, nor before nor after a trauma or a surgery is really symmetrical

Phileemon Eric Payne, MD · Answer

It appears that you sustained a ZMC fracture which involves the orbit, the zygoma or cheek bone and the maxilla which is just under the eye. You should return to your surgery for further follow up and re-evaluation with a CT Face scan to determine if you may have full correction of the position and healing of the bone. Sometimes in the healing process the bone is not in an ideal position. This should be confirmed before undergoing any sort of procedure to try and improve the symmetry with other procedures. I do not recommend reabsorbable fillers to treat this problem as it will leave you frustrated and is a waste of money. The key with any facial fracture trauma is to make sure the bone has healed correctly before trying expensive cosmetic procedures that the insurance company will likely not cover.

What would you recommend to fix my face atrophy and drooping right cheek? (Photos)

Answers (4)

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