Zygomatic fractures

What is a zygoma?

The term zygoma, or zygomatic complex, refers to the part commonly referred to as a the “cheekbone”. It also forms part of your eye socket and joins the top jaw or maxilla. It has an arch which extends backwards (the zygomatic arch) towards the temporal bone and is a common site for breakages in interpersonal violence and contact sports injuries.

What problems are caused by zygomatic fractures?

Zygomatic fractures may cause a range of problems including objective flattening (depression) of the cheek with resultant asymmetry, double vision due to tethering of the eye muscles, temporary or permanent sensory alteration (e.g. numbness and/or pins and needles) and difficulty opening the mouth.

How is surgery performed?

The zygoma is often accessed through small cosmetic incisions inside the mouth, at the upper and/or lower eyelids and within the hairline most commonly. These incisions are kept as discrete and neat as possible. Access enables the zygoma to be “lifted” back into place and secured with titanium miniplates that stay in for life.

What are the risks of surgery?

Generally, the surgery is very safe. Risks can include pain, swelling, bleeding, infection, scarring, hypertrophic or keloid scarring, double vision, sensory alteration, persistent deformity and alteration of the position of the eyelid (e.g. ectropion). Exceptionally rarely, there is a risk of loss of vision. These complications are uncommon however, and most people make an uneventful recovery.

Will I need to stay overnight?

For zygomatic fractures, the key post-operative care is regular eye observations. With this in mind, I will always insist that you stay overnight for these checks.

What is recovery like?

You may have some bruising of the cheek and, not uncommonly, a “black eye” that may take days to weeks to settle down. Initially things will look quite swollen and it is not uncommon for sensory alteration and/or double vision to be worse in the immediate period following surgery until things settle down.