Because occlusion is satisfactory or has been corrected in these patient groups, skeletal augmentation is determined by the aesthetic concerns of the patient. Physical examinations together with standardized photographs are paramount in analysis and surgical planning. Plain radiographs and, particularly, computed tomographic scans with 3-dimensional reconstruction can be useful adjuncts. In certain instances, particularly those patients with significant asymmetries, models obtained from computed tomographic data add the physical dimension to the planning and have been used to manufacture customized implants.
Proper facial balance and aesthetics are enhanced by the appropriate amount of malar or zygomatic prominence. It is a powerful tool that can yield dramatic results.