Sagging of the cheeks do not and should not occur after malar reduction (zygoma reduction), and if it does, revision should be done. However, as the cheekbones get smaller, the skin over the bones possibly moves downward. In this case, it is cosmetically helpful that skin moves downward, and it is one of the medical purposes as well. Cheeks could get saggier if the opened cheekbone gaps are too big, if the skin lacks elasticity, or if you already have had sagging occurred. In this case, lifting could be done simultaneously with the surgery or after the surgery.