Aesthetic Approaches to Zygomatic Fracture Management: Achieving Optimal Outcomes With Minimal Scarring

J Craniofac Surg. 2024 Sep 27. doi: 10.1097/SCS.0000000000010694. Online ahead of print.

Abstract

The zygomaticomaxillary complex is integral to facial aesthetics and is frequently involved in facial fractures. These injuries often necessitate surgical intervention, with open reduction and internal fixation being the standard treatment. This article presents a novel philosophy for managing zygomatic fractures, emphasizing the "Scarless Surgery" technique. The authors' approach prioritizes minimal osteosynthesis material and fixation points while utilizing the least visible surgical access. For isolated zygomatic arch fractures, an intraoral technique is preferred, whereas the frontozygomatic suture is approached through an upper eyelid crease for optimal aesthetic outcomes. The zygomaticomaxillary buttress is accessed through a vestibular mucosal incision and the infraorbital rim benefits from a transconjunctival approach. The findings suggest that fewer fixation points can still yield satisfactory stability and cosmetic results, aligning with literature supporting the efficacy of 1 and 2-point fixations. This modern technique not only minimizes visible scarring but also conforms to the contemporary push for minimally invasive surgical methods. The authors' experience and the existing literature support the efficacy of this approach, reinforcing its viability as a standard practice in the surgical management of facial trauma.