Aesthetic malar recontouring: The zygomatic sandwich osteotomy

Rolf M A Bettens, Maurice Y. Mommaerts, Jonathan M Sykes

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


We have used the ZSO as an alternative for malar augmentation with alloplasts. The technique of the ZSO is relatively simple and fast. In our 10-year experience, we have noted good results. One of the biggest advantages is that the augmentation is very predictable and a symmetrical result was obtained in all 50 bilateral cases. The amount of augmentation that can be achieved with the ZSO is greater than with Powell's original technique, especially in the amount of anterior projection. All patients were satisfied, except for one male who complained of excessive malar volume postoperatively. This was easily corrected by a second procedure. Patient morbidity is low. The only annoying complication was maxillary sinusitis from fragmenting of spacer material (hydroxyapatite or calcium carbonate blocks). This occurred at three sides (out of a series of 105 osteotomies). After treatment of these patients with antibiotics, all spacer materials remained in place, maintaining the final augmentation results. Overall, the ZSO compares favorable in results and complication rates with malar augmentation with alloplasts. This procedure should be learned and considered in any patient desiring augmentation of the malar region.

Original languageEnglish (US)
Pages (from-to)265-277
Number of pages13
JournalFacial Plastic Surgery Clinics
Issue number3
StatePublished - Aug 2002

ASJC Scopus subject areas

  • Surgery


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