Technical Refinements in Reduction Malarplasty: A CT-Based Evaluation With Clinical Follow-Up.

Authors

Nguyen D Huan, Dong H Trung, Nguyen Van Long, Tuan-Anh Hoang

Published in

The Journal of craniofacial surgery. Aug 24, 2026. Epub Aug 24, 2026.

Abstract

Reduction malarplasty increasingly emphasizes structural preservation and precise facial contouring. This study evaluates CT-based and clinical outcomes following a modified L-shaped osteotomy with standardized technical refinements.
Forty-four consecutive patients underwent reduction malarplasty using a modified L-shaped osteotomy with standardized 6 mm bone strip resection. CT scans were obtained preoperatively and at 6 months postoperatively. Quantitative measurements included malar eminence width (MEW), zygomatic medial displacement (ZMD), zygomatic posterior displacement (ZPD), arch setback at the coronoid level (ASC), malar symmetry index (MSI), and soft-tissue projection (STP). Patient satisfaction was assessed using a 5-point Likert scale. Measurement reliability was evaluated using intraclass correlation coefficients (ICC).
MEW decreased significantly from 102.1±3.6 mm to 95.0±3.4 mm, with a mean reduction of 7.1 mm (P<0.001). Mean ZMD and ZPD were 3.3±0.6 mm and 3.2±0.7 mm, respectively, and ASC ranged from 3 to 4 mm. MSI improved significantly, indicating enhanced facial symmetry. STP was preserved or slightly decreased postoperatively. Greater MEW reduction correlated moderately with higher patient satisfaction (ρ=0.46, P=0.004). Transient hypoesthesia occurred in 2 (4.5%) patients and resolved within 3 months. ICC values demonstrated excellent intraobserver (0.91-0.97) and interobserver (0.87-0.94) reliability.
Modified L-shaped reduction malarplasty with standardized 6 mm bone strip resection achieves predictable skeletal narrowing, improved symmetry, and preservation of soft-tissue contour with a low complication rate. CT-based morphometric analysis provides objective validation of surgical outcomes at 6-month follow-up.

PMID:
42635320
Bibliographic data and abstract were imported from PubMed on 24 Aug 2026.

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