Methods for correcting orbital and cheekbone asymmetry and retrusion?

[livelaughlooksmax]

What is the forum consensus on augmenting the cheekbone and infraorbital area?

I've heard ZSO is a bad idea on pre existing asymmetrical zygos (is this true?), Is ZSO possible on one zygo only? I would need 3+mm extra projection on the right zygo than left to address the asymmetry. I'm less than convinced on the aesthetic outcome of custom midface implants, I would need it to extend to the outer canthus of both eyes, a design I have not seen yet. Good infraorbital rim implant results for young adults are seldom. Then there are fillers.

The asymmetry originating from my deformed TMJ joint extends beyond my jaw into the rest of my face on the right hemisphere. While the bones on the left hemisphere are significantly more developed, there is still nagging recession on this side manifesting in NCT, scleral show. Maybe I could get away with lower eyelid retraction after double jaw surgery which in itself may improve NCT and scleral show. But my right zygo/orbital did not grow correctly and needs an osteotomy or implant before soft tissue procedures.

 

[highT]

custom implants. you can specify the projection per side to achieve more symmetrical result

 

[zq336]

I think an implant is probably your best bet...a ZSO only moves the zygomatic arch and does not affect the rest of the zygomatic bone. It's also difficult to correct minor asymmetries when the surgeon is just eyeballing it during surgery. I would get a custom implant going from the infraorbital rim to the back of the arch and also higher up on the lateral canthus if you want. You can have your soft tissue procedures done at the same time.