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العربيةFour Expected Effects of Cheekbone Reduction
- A smaller face
- A softer impression
- A smoother facial line
- A three-dimensional, youthful face
Facial Contouring
Cheekbone Reduction
3D Cheekbone Rotation Surgery: Rotating the Cheekbone Instead of Pushing It In
Cheekbone reduction is surgery that cuts the protruding cheekbone and moves it inward to reduce the width of a face that looks wide.
Table of contents for this page
- What kind of surgery is cheekbone reduction?
- In what cases is cheekbone reduction done?
- Can cheekbone reduction be done in your 40s and 50s?
- How is cheekbone reduction performed?
- How long does recovery from cheekbone reduction take?
- What are the side effects of cheekbone reduction?
- When is revision cheekbone reduction considered?
- How do I get a consultation for cheekbone reduction?
- Face Plus Talk
- Frequently Asked Questions
- Related FacePlus TV Videos
- Related surgeries and procedures worth looking at together
- References
Anesthesia
General anesthesia (administered by an anesthesiology and pain medicine specialist)
Surgery time
1 hour to 1 hour 30 minutes
Hospital stay
A hospital stay of about one day may be needed depending on the surgery
Fasting before surgery
8 hours (not even water)
Daily life
Usually possible to some extent 1 to 2 weeks after surgery
Quitting smoking before surgery
Recommended from 3–4 weeks before surgery (literature recommendation)
01
What kind of surgery is cheekbone reduction?
Cheekbone reduction is surgery that cuts the front body of the cheekbone and the part extending to the side, then pushes them inward and fixes them in place.
In a word, it is surgery that cuts a cheekbone protruding to the front and the side and moves it inward.
The cheekbone is viewed as two parts: the "front cheekbone," which stands out toward the front below the eye, and the "side cheekbone," which extends toward the ear and widens the side line of the face.
Mechanism
The cheekbone consists of the zygoma (the body of the cheekbone) and the zygomatic arch (the arch-shaped bone running from the zygoma to the front of the ear). The prominence of the front cheekbone is mainly shaped by the zygomatic body, and the width of the side cheekbone mainly by the zygomatic arch. In cheekbone reduction, the zygomatic body is cut (osteotomy: cutting the bone) and moved inward and backward, and the rear end of the zygomatic arch is cut, pushed inward, and fixed in place.
In simple terms — The cheekbone is made up of a front body and an arch extending to the side. The body is cut and moved inward, and the back of the arch is cut and pushed inward. Then the cheekbone appears smaller both from the front and from the side.
There is also a method of grinding down the bone surface. However, one review concluded that shaving makes it difficult to reduce the zygomatic arch (the side cheekbone), so cutting and repositioning the cheekbone is the more reliable method.
Face PlusFace Plus Plastic Surgery Cheekbone Reduction Effects
Face PlusWhy Face Plus for Cheekbone Reduction? — 3D Cheekbone Rotation Surgery
Rather than simply pushing the cheekbone in, it is rotated into place, which is more effective for cheekbone reduction. In addition, upward tight fixation helps prevent cheek sagging after surgery, and the back of the cheekbone is also firmly fixed in close contact, minimizing side effects such as malunion.
Face PlusComparison of Conventional L-Type Cheekbone Reduction and Face Plus Cheekbone Reduction
| Conventional L-Type Cheekbone Reduction | Face Plus Cheekbone Reduction | |
|---|---|---|
| Surgical method | L-shaped osteotomy, then pushed inward | Trapezoid osteotomy, then rotated |
| Reduction effect | Slight effect (3–5 mm reduction) | High effect (6–12 mm reduction) |
| Three-dimensional contour | Lacks a three-dimensional contour (simply pushed in) | Three-dimensional contour as it rotates into place |
| Fixation method | Simple fixation at the front, or at the front and back | Upward tight fixation on both sides |
| Cheek sagging | May occur | Less likely to occur |
| Side Effects | Malunion or recurrence possible | Malunion and recurrence are very unlikely |
Face PlusTo those who are worried about facial contouring surgery...
By what criteria do you choose a clinic? How can you minimize side effects, get a satisfying result, and avoid major problems?
From considering surgery and looking into it with interest to finally deciding to have it, a great deal of deliberation is needed. Even choosing a clinic alone involves too many options. And even after choosing a clinic, various worries arise about side effects, surgical results, and so on.
Seeing the people who visit the clinic for consultations or surgery, I have come to know the concerns that they commonly share. If you were ignored or brushed off after surgery, where could you even go to voice your complaint?
These are, in a way, natural expectations and hopes, but in reality, because we hear stories to the contrary through various channels, it is not easy to feel such confidence. It is good to visit several clinics, gather information, and compare. What is unfortunate is that you gain too much information but get buried in a flood of it, which makes judgment even harder.
Listening to people who have had consultations at several clinics, there are so many who are confused because they have a lot of information and knowledge about surgery but find it hard to judge what is important and what is not. In fact, many of them have consulted doctors who perform the surgery often and do it well, and in most cases what they were told is not very different.
The most important thing is to get a satisfying result while minimizing side effects. It is also to hope that if a problem does arise, it will be resolved smoothly.
Face PlusCheekbone Reduction Suited to Each Patient's Condition — Long-Standing Know-How of a Plastic Surgery Specialist Dedicated to Facial Contouring
The cheekbone reduction method suited to each type
Rotation and tight fixation: no more worries about cheek sagging or nonunion!
- Trapezoid osteotomy for a better cheekbone reduction effect
- Surgical planning based on analysis of the facial bone lines, proportions, and shapes
- Bidirectional rotation maintains the three-dimensional contour and improves the reduction effect
- A natural line that is not excessive
- Secure tight fixation to help prevent cheek sagging
02
In what cases is cheekbone reduction done?
It is done when the cheekbones protrude to the side or the front and make the face look wide, or when the area below the cheekbone is hollow and makes the cheekbone look more prominent.
As you read the list below, picture the face in your mirror. If any item applies to you, we check at the consultation whether cheekbone reduction is right for you.
- When the side line of the face looks widest at the cheekbones when seen from the front
- When the front cheekbone below the eye looks prominent when seen from the side
- When the cheeks below the cheekbones are hollow, so only the cheekbones stand out
- When you often hear that your cheekbones make your impression look strong
Even if one of these applies to you, we do not recommend surgery right away. Not every large cheekbone calls for cheekbone reduction. The first of our treatment principles is "We never recommend unreasonable surgery." If a cause other than bone is greater, we will tell you so.
Face PlusFacePlus Cheekbone Reduction Is Recommended for the Following
- A face with protruding cheekbones and no three-dimensional contour
- A face in which both the side cheekbone and the 45-degree cheekbone are well developed
- A face in which both the side cheekbone and the 45-degree cheekbone are well developed and the front cheekbone is flat, so there is no three-dimensional contour
03
Can cheekbone reduction be done in your 40s and 50s?
We do not decide by age alone, but if the cheeks have started to sag, the sagging may become more noticeable after the cheekbones are reduced, so we look at this together.
This is the part that those in their 40s and 50s who are concerned about their cheekbones are likely to be most curious about.
Mechanism
The zygoma and zygomatic arch are the skeleton that supports the cheek soft tissue above them and the SMAS (the facial fascia layer). When the zygoma is moved inward by cheekbone reduction, the width of the support narrows, and the soft tissue detached from the bone for the osteotomy may sink downward. In middle age and beyond, when skin elasticity has declined, this cheek sagging can become more noticeable.
In simple terms — The cheekbone is like a shelf that supports the cheek tissue. If the shelf is narrowed, the cheek tissue above it may come down. At an age when the skin has begun to lose elasticity, this change is easier to see.
Our clinic's principle is to fix the bone firmly and not to reduce it more than necessary. For patients with a lot of cheek tissue, we may also recommend liposuction or lifting together with cheekbone reduction.
For this reason, in consultations with middle-aged patients, we look at the degree of sagging in the cheeks and jawline together with the size of the cheekbones. If the sagging is already evident, surgery to lift the sagging may need to come before reducing the cheekbones.
Methods for dealing with sagging are explained in Facelift surgery information, Mini facelift surgery information, and Thread lift treatment information.
04
How is cheekbone reduction performed?
The usual method is to make incisions inside the mouth and in front of the ear, cut the body and arch of the cheekbone, move them inward and fix them in place, and then close the incisions with sutures (stitches).
| Area | Usual incision | What it does |
|---|---|---|
| Front cheekbone (body of the cheekbone) | Inside the mouth, behind the upper gum | The body is cut, moved inward and backward, and fixed with metal plates or screws |
| Side cheekbone (zygomatic arch) | A short incision inside the hairline in front of the ear | The rear end of the zygomatic arch is cut and pushed inward |
The incision inside the mouth leaves no scar visible on the outside. The incision in front of the ear is kept short and placed inside the hairline or in the crease in front of the ear to hide the scar.
At our clinic, the principle is to completely cut and reposition both the body of the cheekbone and the zygomatic arch (complete osteotomy). The body of the cheekbone is often cut in an L shape. The repositioned bone is fixed with titanium metal plates and screws, and if needed, wires or additional plates and screws are used to reinforce the fixation.
A Word from the Doctor
"In cheekbone reduction in particular, the most important thing is to fix the bone firmly in its proper position during surgery."
Surgery is performed under general anesthesia, and the operating time is 1 hour to 1 hour 30 minutes. Depending on the surgery, a hospital stay of about one day may be needed.
Tests for general anesthesia are done before surgery. An anesthesiology and pain medicine specialist administers the anesthesia. You fast for 8 hours before surgery. You may not drink even water.
We have laid it out in order below.
1. Consultation and planning
Using face photos and CT (a test that images the bone in three dimensions), we look at the shape of the cheekbones and any left-right differences. Please tell us about all medications you take and any conditions you have. Even things that seem minor are fine to mention. Before surgery, tests for general anesthesia are performed.
2. Anesthesia
An anesthesiology and pain medicine specialist administers general anesthesia. When you wake up, the surgery is already over.
3. Incisions are made and the bone is cut
Incisions are made inside the mouth and in front of the ear, and the body and arch of the cheekbone are completely cut along the planned line (complete osteotomy). The body of the cheekbone is often cut in an L shape.
4. The repositioned bone is fixed
The body of the cheekbone is fixed with titanium metal plates and screws in the position to which it was moved inward. If needed, wires or additional plates and screws are used to reinforce the fixation.
5. The incision is closed and compression is applied
The incisions are closed, and a compression band that wraps the face is applied to reduce swelling and bleeding. Depending on the surgery, a hospital stay of about one day may be needed.
05
How long does recovery from cheekbone reduction take?
Generally, you can return to some degree of daily life 1 to 2 weeks after surgery. Swelling lasts longer than this: much of the major swelling goes down during the first month, and the remaining swelling goes down slowly over several months as the contour settles.
If you have work or an important appointment coming up, this is probably what you most want to know. We have written it by time point.
| Time point | Course |
|---|---|
| First few days | Swelling is at its worst. Bruising may extend below the eyes or down to the neck |
| 1–2 weeks | By this time you can usually return to daily life to some extent. While the wound inside the mouth heals, you eat soft food |
| About 1 month | More than half of the swelling goes down |
| Around 6 months | Most of the swelling has gone down and the contour is settling |
| Around 1 year | The remaining swelling goes down a little more |
The point at which you can return to daily life is different from the point at which most of the swelling has gone down. The speed of recovery varies from person to person, and the face right after surgery is not the final shape.
After surgery, you will come to the clinic 2 to 3 times over about 2 weeks. The number of visits and the dates are adjusted according to the surgery and your recovery. Once the day for stitch removal is set, please keep that day if at all possible; the other dates can be adjusted.
So that you do not have to endure recovery alone, the doctor and the nursing team check your swelling, pain, and condition together. The third of our treatment principles is “We see patients more frequently after surgery.”
Precautions after surgery
The key points are keeping force off the cheekbones while the bone heals and keeping the wounds inside the mouth clean.
Please keep the following five points in mind.
- It is best to avoid pressing on or bumping the cheekbone area.
- It is best to avoid lying on your side or sleeping on your stomach.
- It is best to avoid chewing hard or tough food forcefully.
- After meals, rinse your mouth to keep the wound clean.
- Smoking slows wound healing and bone union.
06
What are the side effects of cheekbone reduction?
In addition to swelling and bruising, the following may occur: bleeding, reduced sensation in the cheek and upper lip, left-right asymmetry, nonunion in which the cut and repositioned bone does not join, cheek sagging, difficulty opening the mouth, and injury to the nerve that moves the forehead. Rarely, there are risks related to general anesthesia and the airway, and, very rarely, bleeding inside the head.
This is information you need to know before deciding on surgery, so we have written it out in full without shortening it.
This is surgery that cuts and repositions bone. Please decide only after fully understanding the items below.
Item by item
Side Effects
- Bleeding and hematoma (a collection of pooled blood): Bleeding may occur from the cut bone surface and surrounding blood vessels. If the pooled blood increases quickly, a procedure to drain it is needed.
- Reduced sensation: If the infraorbital nerve (the nerve that exits from the opening below the eye and supplies sensation to the cheek, upper lip, and side of the nose) is pulled or compressed, these areas may feel dull. A temporary change is the most common, but in some cases it remains for a long time.
- Facial nerve injury: If the temporal branch of the facial nerve (the nerve that moves the muscle that lifts the forehead), which runs close to the incision in front of the ear, is injured, movement of the forehead on one side may become weaker.
- Nonunion and malunion: The cut and repositioned bone may fail to join (nonunion), or it may join in a position different from the plan (malunion). If the zygomatic arch does not join, you may feel pain or movement when chewing, and surgery to fix it again may be needed.
- Asymmetry and contour irregularity: The height and width of the left and right cheekbones may differ, or a step or hollow may be felt or seen where the bone was cut.
- Cheek sagging: As the cheekbone support is reduced, the cheek tissue detached from the bone may sink downward, and the cheeks and the nasolabial fold area may look saggy. This is more noticeable when skin elasticity has declined.
- Difficulty opening the mouth: Because of swelling or the effect of the muscle around the zygomatic arch, it may be hard to open the mouth wide for a while.
- Infection: The incision site inside the mouth can become swollen, with fever and pus. If infection develops around the metal plate used for fixation, the plate may need to be removed.
- Problems related to the maxillary sinus (the hollow space in the bone behind the cheekbone): When the body of the cheekbone is cut, the wall of the maxillary sinus may be opened, and, rarely, inflammation may occur.
- Bleeding inside the head: A case in which an instrument went in deep and injured the inside of the skull while the body of the cheekbone was being cut from inside the mouth has been reported very rarely.
- Risks related to general anesthesia and the airway: With general anesthesia, a sore throat and nausea after surgery are common, and, rarely, breathing- or heart-related complications or drug allergies may occur. If the inside of the mouth and the face swell greatly, the airway may narrow, so breathing is checked right after surgery. After a long operation with prolonged lying down, blood clots may rarely form in the leg veins and block the blood vessels of the lungs (deep vein thrombosis and pulmonary embolism).
In simple terms — The four problems below need treatment right away.
- Pooled blood
- Infection
- Difficulty breathing
- Bleeding inside the head
A dull feeling in the cheek, left-right differences, bone that does not join, and cheek sagging become apparent over time, and in some cases they are observed or corrected with another operation.
07
When is revision cheekbone reduction considered?
For cosmetic purposes, revision surgery is mostly recommended 6 months or more after the operation, but depending on the cause, it is sometimes performed right away.
If you are bothered by the result, we fully understand the wish to fix it as soon as possible. That is why we explain separately the cases in which it should be done quickly and the cases in which it is better to wait.
The timing of revision surgery depends on the cause. In cases like the following, it is better to operate right away without waiting.
- When the repositioned bone is not fixed well
- When the bone has not united and is moving
- When there is a wide gap between the cut and repositioned bone segments
- When there is inflammation or infection
Cosmetic revision surgery to refine the shape is mostly recommended 6 months or more after the operation. Before then, swelling remains and the bone and surrounding tissue are still settling into place, so what you see now is not the final shape.
Mechanism
In revision surgery, the scar tissue and adhesions (tissues sticking to each other) left by the first operation must be dissected again (separated between the layers). To correct a nonunion or malunion, the bone must be cut again and fixed, and bone that has already been reduced is difficult to restore to its original size.
In simple terms — A site that has been operated on once has tissue stuck together, so it is harder than the first time. Bone that has been reduced too much is hard to regrow. This is why the amount to be reduced in the first operation is decided carefully.
08
How do I get a consultation for cheekbone reduction?
You can call our main number, 02-541-8500, or apply through Consultation & Booking information.
If you still have questions after reading this, please feel free to ask them at your consultation.
The clinic is located on the 4th floor of Vorati Al Building, 480 Gangnam-daero, Gangnam-gu, Seoul. It is a 1-minute walk from Exit 3 of Sinnonhyeon Station.
At the consultation, please tell us about any facial treatments and surgeries you have had before, the medications you take, and whether you smoke. If you have a facial CT taken previously, you are welcome to bring it.
09
Face Plus Talk
There is something to be careful about after cheekbone reduction. It is making sure the fixed bone does not separate and stays well in place.
— Dr. Park Jung Keun, Plastic Surgery Specialist · Face Plus Talk
First, of course, injury to the surgical area must be avoided. You need to be careful for about a month about opening your mouth wide or clenching your teeth tightly.
Then, about 2 weeks to 1 month after surgery, an X-ray or 3D CT is taken to check whether the fixed bone is staying in place well. After that, it is checked once more at 3 to 4 months. Even after these checks, it is rare for the bone to separate again later. If the early period of bone healing is observed thoroughly, there is usually no major problem.
After cheekbone reduction, many people worry that the bone may not join well or may separate. Side effects such as nonunion and malunion can indeed occur after surgery. However, they mostly occur in the early period after surgery, and if they are found and dealt with quickly, they can be resolved.
The problem, however, is when they are left alone. If the bone has separated and you go on with daily life with it separated for a long time, it may separate more and more. When found and dealt with quickly, it is not a big problem, but if left alone for so long, the problem can grow.
There are broadly two ways it gets left alone for a long time. The first is when the clinic leaves it alone. The patient keeps complaining of discomfort and a feeling of movement, but is simply told to wait 6 months. There is no examination and no X-ray check. The second is when the patient leaves it alone. There is a strange sound and the bone seems to move, but thinking that it is just because of the surgery, the patient lets several months go by.
Both of these cases can lead to a poor outcome. Therefore, the clinic must not ignore a patient's discomfort, and the patient should tell the clinic about any discomfort right away and be examined. X-rays should be checked, and later changes should continue to be followed up. In other words, after surgery, the patient and doctor should meet more often!!! This is extremely important.
If you follow the precautions after surgery well, nonunion after surgery is rare, and even if it does occur, if it is found early, it usually does not develop into a major problem. So I will say it again: it is important for the patient and the clinic to respond sensitively to problems in the early period together.
10
Frequently Asked Questions
What about anesthesia, operating time, and hospital stay for cheekbone reduction?
A board-certified anesthesiology and pain medicine specialist administers general anesthesia, and when you wake up, the surgery is already over. Before surgery, tests for general anesthesia are performed, and you fast for 8 hours before surgery, without even drinking water. The operating time is 1 hour to 1 hour 30 minutes, and depending on the surgery, a hospital stay of about one day may be needed.
After cheekbone reduction, when can I return to daily life, and when does the swelling go down?
You can usually return to daily life to some extent 1 to 2 weeks after surgery. Swelling lasts longer than that: most of the major swelling goes down during the first month, and the remaining swelling goes down over several months.
Do the cheeks sag after cheekbone reduction?
They can. The cheekbone supports the cheek tissue, so when the bone is reduced, the cheek tissue may sink downward. It is more noticeable when skin elasticity has declined, so for middle-aged patients, the degree of sagging is considered together before deciding.
Is the scar from cheekbone reduction visible?
For the front cheekbone, an incision inside the mouth is the usual method, so no scar is visible on the outside. For the side cheekbone, a short incision is often made inside the hairline in front of the ear, which leaves a scar, but it is hidden by the hair and the crease in front of the ear.
11
Related FacePlus TV videos
This links to a video on the Face Plus Plastic Surgery YouTube channel. View All FacePlus TV
12
Surgeries and procedures worth considering together
These are surgeries and procedures often discussed together with this surgery during consultations. Whether to have them together is decided after an examination.
Eye Surgery
Rhinoplasty
Fat Grafting13
References
- Yang DB, Chung JY. Infracture technique for reduction malarplasty with a short preauricular incision. Plast Reconstr Surg. 2004;113(4):1253-61; discussion 1262-3. PMID 15083030. doi:10.1097/01.prs.0000110217.60491.56
- Kim YH, Seul JH. Reduction malarplasty through an intraoral incision: a new method. Plast Reconstr Surg. 2000;106(7):1514-9. PMID 11129179. doi:10.1097/00006534-200012000-00011
- Kim YH, Cho BC, Lo LJ. Facial contouring surgery for asians. Semin Plast Surg. 2009;23(1):22-31. PMID 20567722. PMCID PMC2884897. doi:10.1055/s-0028-1110098
- Myung Y, Kwon H, Lee SW, Baek RM. Postoperative Complications Associated With Reduction Malarplasty via Intraoral Approach: A Meta-analysis. Ann Plast Surg. 2017;78(4):371-378. PMID 27801697. doi:10.1097/SAP.0000000000000913
- Park YY, Kim KK, Park B. A Comprehensive Assessment of Soft-tissue Sagging after Zygoma Reduction Surgery through Artificial Intelligence Analysis. Plast Reconstr Surg Glob Open. 2024;12(8):e6055. PMID 39139838. doi:10.1097/GOX.0000000000006055
- Reategui A, Phillips S, Dinis J, Junn A, Parsaei Y, Yang J, Lopez J, Steinbacher DM. Postoperative Edema Resolution Post-Orthognathic Triple Jaw Surgery: A Three-Dimensional Volumetric Analysis. J Craniofac Surg. 2022;33(2):512-516. PMID 34619733. doi:10.1097/SCS.0000000000008270
- Kim MS. Intracranial Hemorrhage After Reduction Malarplasty: A Narrative Review Focusing on Surgical Technique. J Clin Med. 2026;15(14):5609. PMID 42513523. doi:10.3390/jcm15145609
- Xu B, Anderson DB, Park ES, Chen L, Lee JH. The influence of smoking and alcohol on bone healing: Systematic review and meta-analysis of non-pathological fractures. EClinicalMedicine. 2021;42:101179. PMID 34765953. doi:10.1016/j.eclinm.2021.101179
- Wong J, Lam DP, Abrishami A, Chan MT, Chung F. Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Can J Anaesth. 2012;59(3):268-79. PMID 22187226. doi:10.1007/s12630-011-9652-x
- Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8. PMID 21295194. doi:10.1016/j.amjmed.2010.09.013
Dr. Park Jung Keun · Plastic Surgery Specialist, PhD in Medicine
He personally consults on and performs facial aging treatments such as facelift, droopy eyelid surgery, and thread lift. The doctor personally sees you from consultation through recovery.
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The content of this page is general medical information provided in accordance with the Medical Service Act, and the effects and recovery time of surgeries and procedures may vary by individual. All surgeries and procedures can cause side effects, so please make your decision only after a thorough consultation with a plastic surgery specialist.