Fixation methods after zygoma reduction surgery! Double fixation? Triple fixation?

Effective Fixation Methods After Zygoma Reduction Surgery by Dr. Park Jonglim

As a bone specialist at 345 Plastic Surgery Clinic, I often get asked about the most effective methods of fixation after zygoma reduction surgery. This procedure is designed to reduce and reposition the zygomatic bone, but the fixation techniques used afterward play a crucial role in ensuring proper healing and preventing complications like nonunion.

Understanding the Forces Acting on the Zygomatic Bone Post-Surgery

After performing osteotomy to reduce the zygoma, two main forces act on the surgically repositioned zygomatic bone. These forces primarily stem from the powerful chewing muscles, namely the masseter and temporalis muscles.

  1. Masseter Muscle: This large, powerful muscle connects the zygomatic bone to the mandible and is responsible for chewing. When it contracts, it pulls the zygomatic bone and mandible together, applying a downward force on the zygomatic bone.

  2. Temporalis Muscle: Although it does not directly attach to the zygomatic bone, the temporalis muscle pulls the temporal region of the skull and the mandible together during chewing. The contraction of the temporalis can push the inward-moved zygomatic bone outward due to the muscle’s prominence.

In summary, the forces acting on the zygomatic bone after surgery are:

  • A strong downward force from the masseter muscle
  • An outward force from the temporalis muscle

For the bone to heal and fuse properly, it must remain stable and immobile. Any movement can lead to complications like nonunion (failure to fuse), making strong fixation essential.

The Importance of Strong Fixation After Zygoma Surgery

The fixation method may vary depending on the surgeon's preferences and experience, but the core principle remains the same: securing both the front (zygomatic body) and back (zygomatic arch) portions of the zygoma is crucial for stable recovery.

Fixation Techniques: Two Rows of Screws for Enhanced Stability

In my approach, I use two rows of screws or a rectangular plate that mimics the effect of two rows of screws for fixing the zygomatic body. While a single row of screws can block forces attempting to separate the bones, it is more vulnerable to twisting forces that could cause the bone to shift. Therefore, using two rows or a rectangular plate provides a more stable fixation, reducing the risk of movement.

Fixing the Zygomatic Arch

The zygomatic arch is thinner, making it challenging to secure with multiple rows of screws. In this area, I use a single row of screws, ensuring that the fixation is as strong as possible despite the arch’s delicate nature.

Final Thoughts on Zygoma Fixation

There is no single "correct" fixation method after zygoma reduction surgery. Experienced surgeons develop their own techniques to secure the bones and ensure proper healing. The key is to use the appropriate fixation approach based on the specific anatomy of the patient and the forces at play.

Conclusion: The Best Fixation for Zygoma Reduction Surgery

The success of zygoma reduction surgery largely depends on the choice of fixation method used after the procedure. By securing the zygomatic bone with strong, stable fixation, the risk of complications like nonunion can be minimized, leading to better overall outcomes for the patient.


#Zygoma Reduction Surgery #Zygomatic Bone Fixation #Zygomatic Bone Surgery #Fixation After Zygoma Surgery #Zygomatic Arch Fixation #Zygomatic Osteotomy #Zygoma Nonunion Prevention #Post-Surgery Zygomatic Bone Stabilization #Zygomatic Bone Healing #Surgical Fixation Techniques for Zygoma

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