Cheekbones
Treatments for postoperative problems affecting the cheekbones include:
- Relapse from the place of reduction; while much less common now, a malreduction should be repositioned surgically before the bone unites (otherwise resulting in a malunion).
- Malunion necessitates an osteotomy (cutting) of the broken bone and moving it to a position which best simulates the original position of that cheekbone, then fixing it in the new position with small titanium plates and screws.
- Compression of the infraorbital nerve (the sensory nerve that innervates the upper lip, parts of the nose and the lower eyelid, one on each side of the face) can result in neuropathic pain. Analgesics may help, but sometimes surgical removal of the impinging bone is necessary. There is a real risk of further damage to the nerve by surgery. Alternatives include cryoanalgesia to the nerve.
- Double vision and epiphora (tearing) can be a problem if the orbital floors or walls (eye socket) are involved; see treatment of postoperative problems affecting the orbit.
- Epistaxis (nosebleed) is dealt with by diathermy or nasal packing.
- Scars that will affect the cheek may require scar revision.
- Ectropion and entropion, when scarring pulls the lower eyelid out (ectropion) or in (entropion), is essentially treated by scar revision, with or without skin or mucosal grafting.
- Incorrect positioning of bone(s), leading to an over-prominent or sunken cheekbone can be corrected by post-traumatic osteotomy.
- Altered sensation over the cheek is usually managed medically (with a range of potential medications) if troublesome.