Bone Reshaping Surgery: Scars, Nerve Risks, and Recovery

Osteotomy

Hello Doctor: I would like to ask if surgery to reduce the zygomatic arch will leave any visible scars on the exterior? Where would the scars be located? What is the likelihood of nerve damage during this procedure? If the nerves in this area are damaged, what symptoms might occur (such as facial asymmetry, etc.)? If nerve damage occurs, is there no way to remedy it? After the recovery period, will the patient be able to return to a normal appearance? Could you please recommend a suitable physician for me to consider (someone with skills similar to Dr.
Chen Yu-Rui)? Thank you for your response! Wishing you all the best.

kitty, 20~29 year old female. Ask Date: 2002/10/12

Dr. Luo Qihua reply Plastic Surgery

1.
If the surgery is performed intraorally, the incision will be inside the mouth, leaving no visible scars on the outside, but it may not allow for significant bone reduction.
If the nearby second branch of the trigeminal nerve is affected, there may be numbness in the upper lip, although the likelihood of this occurring is generally low.

2.
For more extensive zygomatic arch modification surgeries, it may sometimes be necessary to consider an osteotomy, which would require an external approach.
The incision would be similar to that of a craniotomy, resulting in a longer scar, but it would be hidden behind the hairline and would only be visible upon close inspection.
Care must be taken to avoid damaging the nearby branches of the facial nerve.
Injury to this nerve can result in the loss of forehead wrinkles on the affected side and elevation of the eyebrow, leading to facial asymmetry.
It may also cause the upper eyelid on the affected side to not close completely, potentially resulting in dry eye syndrome in the future.
If the nerve is merely stretched, recovery is usually easier; however, if the nerve is severed, recovery becomes much more difficult.
3.
Dr.
Chen Yu-Rui has one of the top experiences in this field in Taiwan.
Since you already know he is an excellent physician, you should consider consulting him.

Reply Date: 2002/10/12

More Info

Bone reshaping surgery, often referred to as facial contouring or orthognathic surgery, involves modifying the structure of the bones in the face, including the cheekbones (zygomatic bones) and jaw. This type of surgery can enhance facial aesthetics and improve function, but it also comes with certain risks and considerations that patients should be aware of.

Scarring
One of the primary concerns for patients undergoing bone reshaping surgery is the potential for scarring. The location and visibility of scars depend on the surgical technique used. In many cases, surgeons aim to make incisions in less visible areas, such as inside the mouth or along natural skin folds, to minimize external scarring. However, if incisions are made externally, there may be visible scars on the skin. The extent of scarring can vary from person to person, influenced by factors such as skin type, healing ability, and the surgeon's technique. Generally, scars can fade over time, but they may not completely disappear.

Nerve Risks
Another significant concern during bone reshaping surgery is the risk of nerve damage. The facial region is rich in nerves, including those responsible for sensation and movement. The zygomatic arch, for instance, is in close proximity to several important nerves, including the facial nerve, which controls facial expressions. While experienced surgeons take great care to avoid nerve injury, there is still a risk, particularly if the surgery involves extensive reshaping or if there are complications during the procedure.

If nerve damage occurs, the consequences can vary. Patients may experience symptoms such as numbness, tingling, or weakness in the affected areas. In some cases, this can lead to conditions like facial asymmetry or difficulty with facial expressions, commonly referred to as "crooked smile" or "facial droop." The severity of these symptoms depends on the extent of the nerve injury.

Recovery and Rehabilitation
Recovery from bone reshaping surgery typically involves a healing period during which swelling and bruising are common. Patients may need to follow specific post-operative care instructions, including dietary restrictions and activity limitations, to promote healing. The initial recovery phase usually lasts several weeks, but complete healing and final results can take several months.

Physical therapy or rehabilitation may be recommended to help restore function and improve any residual issues related to nerve damage. While some nerve injuries can heal over time, others may not fully recover, leading to lasting effects. In cases of significant nerve damage, surgical intervention may be necessary to repair the nerve, but outcomes can vary.

Conclusion
In summary, bone reshaping surgery can provide significant aesthetic and functional benefits, but it is essential to consider the risks of scarring and nerve damage. Patients should have thorough discussions with their surgeon about the potential outcomes, risks, and recovery process. It is also advisable to seek a qualified and experienced surgeon, preferably one who specializes in facial surgeries, to ensure the best possible results. If you are looking for a surgeon with expertise similar to Dr. Chen Yu-Rui, consider seeking referrals from trusted medical professionals or researching board-certified plastic surgeons who specialize in facial contouring.
Ultimately, informed decision-making and careful planning can help mitigate risks and enhance the likelihood of a successful outcome.

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