Surgical Approaches for Facial Bone Surgery
Considerations on facial aesthetics, facial expression muscles, branches of the facial nerve and sensory nerves must be made before the placement of incisions on the face.
The intraoral approach is the main approach for most facial bone contouring surgeries, as incisions in the oral cavity allow superb exposure of most of the facial skeleton with a completely hidden scar.
The bicoronal approach is a versatile surgical approach to the upper and middle facial skeleton including the zygomatic arch. The scars can be hidden within the hairline while providing excellent access.
Transcutaneous incisions such as the Gillies’ approach and incision on the sideburn region are used to excess the zygoma. Scars from the Gillies’ approach can be hidden within the hairline, while sideburn incisions allow direct excess to the posterior zygomatic arch.
Approaches through the lower eyelid, including the subciliary incision or the transconjunctival incision, offer good exposure to the inferior orbital rim, lower part of the lateral orbital rim and the upper region of the zygoma body. Especially in transconjunctival approaches, the scar is hidden within the conjunctiva.
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