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Egro et al. Plast Aesthet Res 2019;6:15 I http://dx.doi.org/10.20517/2347-9264.2019.31 Page 3 of 4

complex cases where the zygoma is comminuted in ZMC fractures, we advocate for the use of a bicoronal
approach to re-establish adequate anteroposterior projection and width of the face.

Lastly, despite ones best efforts of improving the aesthetic contour by fixating the ZMC fractures, some
postoperative asymmetry may persist. We believe that autologous fat grafting (AFT) plays a crucial role in the
secondary reconstruction of facial deformities and an increasing level of evidence demonstrates its benefits.
In a prospective study of AFT for posttraumatic and postsurgical craniofacial deformities, Bourne et al. [11]
demonstrated that AFT provides a safe and minimally invasive alternative to traditional methods (such as
regional flaps and prostheses) to restore normal and symmetric facial morphology. AFT allows for better
control of tissue volume and improves the quality of scarring and skin. The study concluded that for
craniofacial defects, AFT is predictable and effective and reaching volume stability at 3 months.

Ongoing lack of consensus of the surgical management of ZMC fractures makes it challenging to develop
a widely accepted treatment protocol. We commend the authors for this study and look forward to future
research to evaluate optimal management of ZMC fractures.

DECLARATIONS

Authors’ contributions
Made substantial contributions to this review of the literature as well as the writing of the commentary:
Egro FM, Konanur A, Stofman GM

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

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