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Maxillofacial Surgery
The Malar Region
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
11 sections · 71 slides
Overview
- What this topic covers
The cheekbone and why it matters
Naming, and its place in facial attractiveness
- The most recognisable feature of the midface
- The cheekbone as artists have drawn it
- Where the names come from
- Why a bone is named after a yoke
Anatomy of the zygomatic bone
The bone, its muscles, and the arch it helps build
- The bone that makes the bump
- Landmarks of the zygomatic bone on the skull
- What to notice on the skull
- The muscles that lift the smile
- How the zygomatic arch is built
- The arch and its front pillars
Clinical evaluation
Four checks, and the views that reveal them
- The four things you check every time
- What each of the four checks means
- Asymmetry of the cheek region
- Which views to look from
- Looking at the cheek region from above and below
- Judging cheek projection from an oblique superior angle
Bizygomatic width and facial proportion
The widest part of the face, and what it is measured against
- The face should be widest at the cheekbones
- Facial index: height against width
- Say which height you mean
- Why the label matters
- The three lateral promontories of the face
- Putting numbers on the three widths
- What the normative table below is for
- Facial widths and total face height in white Caucasians (normative values based on original data from Farkas)
- Relative width beats absolute width
- Who may benefit from malar augmentation
Malar position
Where the eminence should sit on the face
- Where the eminence sits
- Two landmarks that fix the eminence
- The mild hollow below the cheekbone
- Locating the cheek hollow on the face
- Height of malar contour
Malar projection and sagittal contour
Normal, flat, or too prominent
- Three ways a cheekbone contour is described
- Reading projection in frontal and profile view
- A flat cheekbone region
- Look at the upper jaw as well
- Feel the bone, do not just look at it
- Palpating the cheek region
Finding the area of maximal projection
Six published ways to mark the peak of the cheekbone
- Why the peak has to be marked
- Hinderer's crossed lines
- Crossed lines marking the upper outer quadrant
- Wilkinson's method
- Silver's malar prominence triangle: the steps
- Terms used in Silver's triangle
- The malar prominence triangle
- Powell's analysis
- Locating the prominence from a CT-based analysis
- Prendergast and Schoenrock method
- The methods do not all agree
- Terino's zones of the malar and midfacial region
- Terino's zones, continued
- How to use the zones
- Zonal map of the malar and midfacial region
The three-quarter view
Two checks that only work at an angle
- Setting up the oblique lateral view
- The S-shaped curve from brow to cheekbone
- The brow-to-cheekbone curve in a Renaissance study
- The same curve in a Leonardo study
- The curve in an ancient portrait bust
- The lower part of the frontozygomatic angle
- Splitting the frontozygomatic angle at the eye corner
- How to read the 78-80 degree figure
Correcting malar deficiency
From diagnosis to the choice of operation
- What to establish before choosing an operation
- Two clinical pictures, two routes
- When only the cheekbone is back
- When the whole midface is back
Summary
What to carry away
- Key points: anatomy and naming
- Key points: examination and proportion
- Key points: position, projection, correction
- References
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition