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Postoperative Complications Associated With Reduction Malarplasty via Intraoral Approach: A Meta Analysis

Myung, Yujin MD, MS; Kwon, Heeyeon MD; Lee, Sang Woo MD, PhD; Baek, Rong-Min MD, PhD

doi: 10.1097/SAP.0000000000000913
Aesthetic Surgery

Background Each year, thousands of patients, particularly Eastern Asians, receive reduction malarplasty to achieve a more feminine and slender facial appearance. To date, there lacks a systematic analysis regarding the postoperative complications related to this procedure. Hence, the authors performed a comprehensive literature review with meta-analysis.

Methods Articles were searched and reviewed using the MEDLINE and Embase databases. Among the studies regarding surgical outcomes after reduction malarplasty, articles with explicit reports and clear numbers of postoperative complications were selected for meta-analysis. Additionally, manual searches were made from references of selected articles.

Results A total 14 retrospective review articles that represented 3149 cases were reviewed, and 7 different postoperative complications were analyzed. The complication that showed the highest weighted mean percentage of frequency was transient sensory weakness, with 5.8% (Z = −18.012; 95% confidence interval, 4.3–7.6%), followed by drooping (2.8%), nonunion (2.2%), asymmetry (1.8%), mouth opening restriction (1.8%), uncontrolled bleeding (1.3%), and facial nerve injury (0.9%).

Conclusions According to our meta-analysis of previous literatures, the aggregated rates of various complications related to reduction malarplasty were not high. Among the various complications, short-term sensory weakness was shown as the most frequent complication, emphasizing the necessity of patient warning and education before and after the operation. Moreover, soft tissue drooping and bone nonunion are also not rare and surgeons should be aware of these complications.

From the *Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine; and †DA Plastic Surgery Clinic, Seoul, Korea.

Received April 27, 2016, and accepted for publication, after revision August 10, 2016.

Conflicts of interest and sources of funding: none declared.

Reprints: Rong-Min Baek, MD, PhD, Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea. E-mail:

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