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The zygoma and its arch is important in contouring and symmetry of the midface. In western, the prominent zygoma and its arch is considered as esthetic point, but in orient, it is considered as handicap in that point. The methods of reduction of prominent mala were as follows; augmentation around the zygoma by insertion of implant or dermofat graft, shaving of the zygoma and its arch, and osteotomy technique of the zygoma and its arch. The methods of approach to the zygoma and its arch are temporopreauricular, intraoral(buccovestibular), bicoronal, subciliary(transcutaneous eyelid) incision or combined approaches.
The authors have experienced reduction malarplasty in 12 cases from 1989 to 1994. The method of reduction of zygoma and its arch was osteotomy technique and the method of approach to the zygoma was combined method of temporopreauricular and intraoral incision and if necessary, subciliary incision was added in old age. Author's method showed main advantages of avoiding of visible scar by intraoral and temporopreauricular approach and definite effect of malar reduction by osteotomy technique.
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