Cheekbone Reduction
When the cheekbones sit less prominent and less wide, the middle of your face looks softer and more balanced — so that when you look in the mirror, you see yourself, more at ease and more in harmony.
Is this right for you?
Cheekbone reduction is surgery that reshapes the zygoma — the bone that projects on either side of the midface, made up of the front part (the body of the cheekbone) and the arch that runs back toward your ear. Your surgeon cuts this bone, moves it inward, and fixes it in its new position, so the cheekbone sits less forward and less wide. The middle of your face then looks slimmer and softer. Because this is surgery on the bone itself, whether it suits you depends a great deal on your underlying bone structure. Here is how to get a sense of whether you fall within the group it tends to help.
This may be a good fit if
- You are 18 or older, when the facial bones have finished growing, and you are in stable health.
- Your cheekbones project forward or spread wide to the sides, which makes the middle of your face look broad or angular compared with what you would like.
- This projection comes mainly from the cheekbone itself, rather than from fat or soft tissue — something your surgeon will confirm through an examination and imaging.
- You understand that this is bone surgery that needs anesthesia and a real recovery period, and you hold realistic hopes for a balanced change rather than a different face.
- Your oral health is stable, with no active infection in the jaw or face.
This may not be right if
- The fullness in the middle of your face comes mainly from fat or soft tissue rather than from the cheekbone — in that case, cheekbone reduction will not address it, and your surgeon will talk through other options with you.
- The skin and soft tissue over your cheeks are already loose — once the bony support beneath is lowered, the skin may sag further, so your surgeon will weigh this carefully and be honest with you about it.
- You have a health condition that is not yet under control, a bleeding disorder, or an active infection in the teeth, jaw, or face; or you are pregnant or breastfeeding, in which case it is usually wise to wait.
- You hope to look exactly like someone else, or you want a change beyond what your bone structure can safely allow.
How it works
It all begins with an examination and a consultation. A specialist in Plastic and Aesthetic Surgery — the same person who will perform your operation — will assess your facial proportions, how far the cheekbones project and spread, the thickness of the soft tissue, and the condition of the skin over your cheeks. You will usually have imaging taken so your surgeon can see the structure of the cheekbone clearly and plan where to cut. You will also have the routine pre-operative tests and be seen by the anesthesiologist.
There are a few things to prepare before the day of surgery. You will be guided to stop certain medications that can increase bleeding, such as those containing Aspirin, and to fast for a set period before your operation as directed. The surgery is usually carried out under general anesthesia, meaning you sleep through the whole operation. How long it takes varies with how much work is involved.
The incision is usually placed inside the mouth, along the upper gum, to reach the body of the cheekbone; in many cases a small incision in front of the ear or within the sideburn hairline is also needed to reach the zygomatic arch. Through these openings, your surgeon cuts the cheekbone at the planned site, moves the bone inward to reduce both its projection and its width, then fixes it with small plates and screws so it heals in its new position. Here is the heart of it: your surgeon adjusts with restraint and keeps the two sides balanced, so the midface looks slimmer while staying in harmony with your other features.
Throughout, your surgeon works carefully around the important structures that sit near the cheekbone — including a branch of the facial nerve that runs close to the zygomatic arch and controls the muscles of the forehead and around the eyes. Once the bone has been reshaped and fixed, your surgeon controls any bleeding, closes the incisions, and usually applies a shaping compression dressing over the cheeks. In some cases a closed drain is placed for a short time, and there is often a hospital stay for monitoring afterward.
Realistic expectations
The aim of this surgery is to make the middle of your face less prominent and less wide, softer and more balanced, by reshaping the cheekbone. Swelling across the face afterward is considerable and lasts a while, so patience matters: the new shape of the cheeks only appears gradually as the swelling settles, and the result is considered final after a few months. So that your hopes sit in the right place, here are a few things it does not set out to do.
What this will not do
- It will not create a face that matches a photo or looks like someone else — the result depends on your own bone structure and soft tissue.
- It will not address fullness caused by fat or soft tissue over the cheeks, if the cheekbone is not the main reason for it.
- It will not tighten skin that has already loosened; in people whose skin has less elasticity, lowering the bony support beneath can sometimes leave the cheeks looking more lax.
- It will not make the two sides completely even — every face already has slight differences between the left and right, and these can remain after surgery.
Recovery
This is bone surgery, so the first days bring real swelling, bruising, and tightness across the cheeks and midface; opening your mouth and chewing are also difficult for a time. Most people manage this well with the medication your surgeon prescribes and a soft diet. The milestones below are a rough guide — everyone heals at their own pace, and if you have other procedures done at the same time, progress may be slower.
- The first few days
- You usually stay in hospital for monitoring and then go home as directed. Swelling and bruising over the cheeks build up and peak at around 3 to 5 days. You take pain relief and antibiotics as prescribed, apply cold compresses as instructed, wear the compression dressing, eat liquid or soft foods, and keep your mouth clean because there is an incision inside it.
- Roughly the first 1 to 2 weeks
- The most obvious swelling begins to ease. Stitches inside the mouth usually dissolve on their own, while any incision on the skin in front of the ear or in the hairline is checked or has its stitches removed at your follow-up visit. Many people consider returning to work during this time, depending on the nature of their job and how much swelling remains.
- Around 3 to 6 weeks
- Swelling settles a great deal, and eating gradually returns to normal. It is still wise to avoid hard knocks to the face and strenuous activity, as your surgeon advises, because the bone needs time to heal firmly.
- Around 3 to 6 months
- The last of the deep swelling fades, the contour of the cheekbone shows clearly, and the bone is stable. This is when the result is considered final.
Risks & safety
Most cheekbone reductions carried out by the proper principles go smoothly. But this is surgery on the bone, in an area with an important nerve and tied to the support of the cheek, so there are risks worth knowing beforehand — and knowing them clearly helps you decide well. Your surgeon will go through them with you in detail.
- Loosening of the soft tissue over the cheeks after surgery, because the bony support beneath has been lowered; this risk is more pronounced in people whose skin has less elasticity.
- Injury to the branch of the facial nerve that lies near the zygomatic arch, which can affect — temporarily, or rarely for longer — the muscles of the forehead and around the eyes.
- Numbness or a temporary change in sensation over the cheeks, which usually improves over time.
- Slow healing of the bone, or the bone shifting or moving at the cut site, which sometimes needs further surgery.
- Bleeding or a collection of blood, and infection, especially given the incision inside the mouth.
- Unevenness between the two cheekbones, or a degree of reduction that falls short of what you hoped for, which sometimes needs a revision later.
- Risks related to general anesthesia.
How we do it
Cheekbone reduction is surgery that cuts and moves bone in the midface. It calls for a clear grasp of the anatomy — in particular the path of the facial nerve branch near the zygomatic arch — and a cutting plan based on your own imaging. The crux lies in adjusting the bone evenly on both sides and fixing it firmly so it heals in the right place. For these reasons, the operation needs to be performed by a specialist in Plastic and Aesthetic Surgery, at a hospital licensed for aesthetic surgery. These conditions are bound up with your safety; they are not minor details.
At The Gioi Dep, the person who examines and advises you is the same person who performs your surgery, so what the two of you discuss about the projection of your cheekbones and the state of your cheek skin feeds straight into the plan. Your surgeon will be candid about what your bone structure allows — and about what it does not, such as the chance of the cheeks sagging if your skin has less elasticity — before you decide. Every case includes a pre-operative anesthesia review by an anesthesiologist, with monitoring and a hospital stay afterward to the hospital's standard.
Frequently asked questions
Does cheekbone reduction leave a scar on the face?
The main incision sits inside the mouth, so it leaves no visible scar. Many cases need a small additional incision in front of the ear or within the sideburn hairline to reshape the zygomatic arch; this one is hidden and usually fades over time. Your surgeon will explain the exact incisions for your case during the consultation.
Is there a lot of pain?
Pain, swelling, and difficulty opening your mouth in the first few days are normal, because this is bone surgery. Most people manage well with the medication your surgeon prescribes, and you feel noticeably more comfortable once the swelling starts to ease.
How long will I need off work?
Many people consider returning to work within about one to two weeks, depending on the nature of their job and how much swelling remains. Because facial swelling is fairly obvious in the early stage, it is wise to allow yourself comfortable time off.
After cheekbone reduction, will my cheeks sag?
This is a real concern and deserves serious thought. When the cheekbone that supports the area beneath is lowered, the skin and soft tissue over the cheeks can follow and loosen, especially in people whose skin has less elasticity. Your surgeon will assess the condition of your skin during the examination, use a fitting fixation technique, and talk frankly about this risk before you decide.
Will the result look natural?
The goal is for the middle of your face to look less prominent and less wide, soft and in harmony with your other features — not a face that matches a photo. The result depends on your own bone structure and soft tissue, and it only appears gradually as the swelling settles. Adjusting the bone with restraint and keeping both sides balanced is what helps the result look natural.
How long until the swelling is fully gone?
The most obvious swelling usually eases within the first few weeks, but the deep swelling takes much longer. The final contour of the cheekbone often shows clearly only after a few months, once the bone has settled. This calls for patience.
Once the bone is cut, will it heal and stay strong?
The bone that is moved is fixed with small plates and screws so it heals in its new position, and once it has healed firmly, the bone is as strong as before. While it is healing, you need to avoid hard knocks to the face as your surgeon advises. In a small number of cases the bone heals slowly or shifts, and your surgeon will keep an eye on this at your follow-up visits.
Will I have local or general anesthesia?
Cheekbone reduction is usually carried out under general anesthesia, meaning you sleep through the whole operation. An anesthesiologist will examine you and talk with you beforehand, and you will be monitored both during and after surgery.
What is eating like after surgery?
In the first days you eat liquid or soft foods and keep your mouth clean as instructed, because there is an incision inside it. Returning to normal chewing happens gradually, following your surgeon's guidance.
Am I too old to have this?
There is no rigid age limit. What matters more than the number is your overall health, the quality of your bone, and the elasticity of your skin — because skin tends to be less elastic with age, the chance of the cheeks sagging after surgery needs careful thought. Your surgeon will weigh these factors during the examination, so that together you can see whether this approach suits you.
The next step
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The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.