Abstract
Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after
nasal bone fractures. The zygoma, with its location and multiple points of articulations,
lends itself to both facial structure and esthetics. Secondary ZMC deformities are
complications of inadequate primary correction, delayed repair, or lack of repair.
Secondary revisions of ZMC aim to correct ZMC displacement and projection and to address
orbital discrepancies. Extensive correction involving significant orbital and malar
defects requires zygomatic repositioning osteotomies and would greatly benefit from
the utilization of virtual surgical planning, intraoperative navigation, and imaging.
Minor corrections in malar projection can be corrected by onlay grafting and soft
tissue augmentation and resuspension. Isolated or minor orbital corrections can be
managed by autogenous or alloplastic material to restore lost orbital volume and anatomy.
Keywords
ZMC - secondary reconstruction - enophthalmos - onlay graft - surgical navigation
