New Method for Improving Midface Contour: Zygomatic Microliposuction with Temporal and Buccal Fat Grafting.

BACKGROUND: In Eastern aesthetics, a prominent zygomatic region is considered coarse and unattractive, often resulting from protruding zygomatic bones, fat accumulation, and temporal and buccal depressions. Traditional treatment-focused on osteotomy-is associated with trauma and complications and ignores the influence of facial fat compartments on aesthetic outcomes. OBJECTIVES: To explore the clinical effects of zygomatic microliposuction with temporal and buccal fat grafting in treating a prominent zygomatic region. METHODS: A retrospective analysis was conducted on 27 patients who underwent zygomatic microliposuction combined with either temporal and buccal fat grafting (n = 15) or temporal fat grafting only (n = 12). The Hollow Severity Rating Scale (HSRS), the temporal-zygomatic-buccal angle, Face-Q™ scale, and self-evaluation questionnaire were completed before surgery and 1 year postoperatively to evaluate and compare surgical outcomes and patient satisfaction. RESULTS: Temporal HSRS scores decreased from 2 (2, 3) to 1 (1, 2) (P < 0.001), and buccal HSRS scores in 15 patients decreased from 2 (2, 2.5) to 1 (1, 1) (P < 0.001) from pre- to postsurgery. The median temporal-zygomatic-buccal angle measured on standardized preoperative frontal photographs of the 27 patients was 161° (160°, 162.5°), which significantly increased to a median of 167° (166°, 169.5°) postoperatively (P < 0.01). The Face-Q™ score was 21 (19, 22) [median 87.5 (79.2, 91.7) for standard score points] with 74.07% of patients scoring ≥80 points. CONCLUSIONS: Zygomatic microliposuction with temporal and buccal fat grafting for the treatment of zygomatic hypertrophy minimizes surgical trauma and has a high satisfaction rate, with a low incidence of postoperative complications. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .