Cheekbone (Zygoma) Reduction

A wide face can come from the front of the cheekbone, the side arch, the soft tissue on top, or a mix of all three, and each needs a different approach. Your surgeon uses facial photos and a 3-D CT scan to separate bone structure from cheek fat and muscle. We show you the scan during your consultation so you can see the bone structure that is creating the width and understand what the surgery will and will not change.

The goal is a natural reduction that keeps the front cheekbone projecting forward so the face still has dimension, not maximum narrowing that flattens the mid-face. Removing too much bone reduces the structural support for your cheek soft tissue and can make sagging more visible. Your surgeon plans cuts that reduce the side width while preserving the front cheekbone where it gives your face shape and lift.

The cheekbone body and arch are cut at planned points, then the bone segment is moved inward or rotated to reduce width, and fixed with small plates and screws so it heals in the new position. The design preserves the orbital rim and the front cheek projection. Your surgeon shows you the planned cut lines on your 3-D scan so you can visualize what is being moved and how it will be secured.

The plates and screws are designed to stay in place permanently and sit flush against the bone so they are not normally felt through the cheek. They can be removed later if they cause irritation or discomfort, though this is not common. We discuss the material, position, and whether removal is likely to be needed, including what the recovery from hardware removal would look like if it ever became necessary.

Stable bone contact and solid fixation with plates and screws are the main tools for preventing the cheekbone from shifting or failing to heal. The cuts are designed so bone meets bone in a way that encourages healing. Your surgeon also limits pressure on the area during recovery with clear instructions about sleeping position, chewing, and activities, because early pressure is one of the biggest threats to stable healing.

Reducing the cheekbone removes some of the bony platform that holds up the cheek soft tissue, which can lead to subtle sagging, especially if the tissue was already beginning to drop. The risk is higher with aggressive reduction. Your surgeon accounts for your soft-tissue quality when deciding how much bone to take and may recommend adding a lifting or volume procedure if the support loss is likely to show.

Major swelling improves over 2 to 3 weeks, but residual cheek numbness, firmness, and limited mouth opening can take several months to fully resolve. You will not be able to chew normally or sleep on your side for a while, and contact sports wait until the bone has united. We give you a phased recovery timeline and see you regularly to confirm the numbness is shrinking and the opening is returning.

Soft foods are the rule for the first weeks, and normal chewing returns only once your surgeon confirms the bone is stable and chewing does not cause pain. Side sleeping and contact sports wait for bony union, which can take several months. We advance your diet and activities based on how your healing looks at each check, not on a fixed calendar date.

Pre-existing asymmetry is measured on your 3-D CT scan before surgery, and your surgeon plans slightly different cuts or rotation on each side to bring the cheekbones closer to balance. The goal is better symmetry, not perfect mirroring, because no face is identical on both sides to begin with. We review your scan and photos together so you see the pre-existing differences and understand which ones are correctable.

The nerve that supplies feeling to the cheek, upper lip, and gum runs close to the cheekbone, so temporary numbness in these areas is expected. Permanent numbness is less common but possible, and the nerve that controls facial movement is in a different zone and is rarely affected. Your surgeon maps the expected sensory territory before surgery and checks how it is recovering at each follow-up visit.

Removing cheekbone width can sometimes leave the face looking flatter or make soft tissue sagging more visible, and fat grafting or a lifting procedure can restore the lost three-dimensional balance. Your surgeon discusses during the consultation whether bone reduction alone will give a harmonious result or whether a complementary soft-tissue step is also warranted. We plan the full picture, not just the bone cut.

Revision depends on what went wrong: if too little bone was removed, a secondary reduction may help. If too much was taken, a bone graft, custom implant, or fat grafting can restore projection, and lifting can address sagging. Over-reduction is harder to fix than under-reduction, which is why we take a conservative approach in the first surgery. A consultation is the best way to weigh what is possible against your current bone and soft tissue.