Follow-Up Question: The maxillofacial surgeon says not to operate. I have the CT scan here. (photo)

It looks minor, but I no longer have a right cheekbone. This is a follow up to my first question, but I have the picture now. Maybe I can get a non-major plastic surgery instead of a surgery to modify the bone? I am considering going to USC to get a correction. I don't seem to have entrapment or double vision except for things extremely close. maybe this is why they are hesitant to operate. I know I'll never be perfect again, but I am worried and don't want to be ugly

Doctor Answers 3

Time is key

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Not sure how far out from the injury.  Generally, the bone can be adjusted in the first three weeks before there is much healing.  After that the surgery is much more difficult.  Very good there is no entrapment.You will need to seek out some second, and third opinions.

Tripod, cheek, orbit fracture

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You appear to have a Tripod fracture (cheek bone, orbital bone). Best to see an oculoplastic specialist soon.  See following link.

ZMC fracture

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Thank you for your question and image.  The image of the 3D-CT scan shows a right sided ZMC (zygomatico-complex) fracture also known as a Malar fracture.  Your flattened cheek can result from depression of the main segment or the union of the arch.  If this is a recent injury (within the past 2 weeks), I'd recommend you quickly see a specialist with experience in trauma who can evaluate you and determine what needs to be done.  If you have a noticeably flat cheek, this is certainly an indication to correct the fracture.  If you are outside the window where the bone could be moved without re-breaking it, then the operation becomes more complicated and there is no rush to be evaluated.  If this is the case, then you have several options to correct the problem including the aforementioned re-breaking the bones, cheek implant (prefabricated or custom), and fillers.  All the best!

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