What is Masseter Hypertrophy? Can Masseter Hypertrophy Be Treated?Dr Sanchaita Kohli
Masseter hypertrophy is a common condition involving increase in the size, bulk, and width of the masseter muscle. The masseter muscle is the main jaw muscle, helping the opening and closing of the jaw. It often bulks up from overuse. When this size increase crosses the standard width, it is considered hypertrophied, and you need masseter hypertrophy reduction surgery for permanent correction.
Depending on the presentation of the masseter muscle, you may have unilateral or bilateral masseter hypertrophy. Unilateral masseter hypertrophy refers to the muscle bulking up on one side of the face. Bilateral hypertrophy is seen on both sides of the face. Unilateral hypertrophy often causes an unbalanced, asymmetrical face, while bilateral hypertrophy leads to an overall square face shape because of excess thickness at the back of the lower face on both sides.
Causes of Masseter Hypertrophy
As the primary cause of masseter hypertrophy is muscle overuse, surgeons generally target the underlying cause first. This targeting ensures that the masseter hypertrophy reduction surgery is most effective, with no chance of the condition returning.
The reasons your masseter muscles bulk up include:
- Parafunctional Habits: When you clench or grind your teeth during non-food-related activities (gum chewing and tobacco chewing).
- Bruxism: A parafunctional habit, bruxism is a stress response where you voluntarily or involuntarily clench your jaw or grind your teeth.
- Unhealthy Teeth on One Side: When you use one side of your mouth more than the other due to decayed or missing teeth on that side, it can lead to unilateral muscle hypertrophy.
- Malocclusion: When you have crooked or misaligned teeth, you may use one side of your jaw more than the other, putting in extra work to eat and have your teeth function normally on that side.
By treating the underlying cause, your surgeon ensures that the condition does not recur after surgery.
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How to Test for Masseter Hypertrophy
Before opting for masseter hypertrophy reduction surgery, you need to ensure that you do have this condition. Various signs point to this condition. One of the most distressing complications of masseter hypertrophy is the associated pain.
The overworked muscles are often fatigued, leading to tenderness and pain. This pain appears in spontaneous bouts while chewing or when your jaw is stiff first thing in the morning.
The main test, also called the clench test, involves grinding or clenching your teeth, making the masseter muscles more prominent. Your maxillofacial surgeon in Delhi then examines the bulge for asymmetry and exaggerated prominence. A trained hand goes a long way in determining if your muscle is hypertrophied.
Other tests include ultrasound imaging that can measure muscle thickness in millimetres or centimetres to see if it exceeds the standard thickness. This test also reveals any discrepancies, especially when done at both clenched and resting stages.
The pressure of the masseter muscle can affect the underlying jawbone, too. The jawbone may increase in length and width with the muscle, with bones jutting out downwards and sideways. Your maxillofacial surgeon in Delhi may perform additional procedures like jawline contouring to combat these asymmetries.
You need these tests because, on the surface, many conditions may seem like masseter hypertrophy. If you have a tumour or cyst in your masseter muscle, that can make it seem hypertrophied. However, if the same treatment path is employed, you put yourself at massive risk since the very diagnosis is wrong. This makes it important to make sure that your treating doctor is not only a good surgeon, but also a good clinician. Only expert maxillofacial surgeons with experience in treating these conditions should be sought for correction.
Treatment Options: Botox and Masseter Hypertrophy Reduction Surgery
The two main treatment options are Botox injections and surgery. Botox is a temporary fix, injected into the masseter muscle, making it weaker and decreasing the pain. Simultaneously, the bulk reduces since Botox decreases muscle electrical activity, paralysing the muscle a little. Function and activity decrease, and the muscle becomes smaller with time.
You will need Botox injections every few months to keep your masseter relaxed. Additionally, this is only useful if there is no change in jawbone size. If you want a permanent solution and jawline contouring, you would need corrective surgery.
Masseter Hypertrophy Reduction Surgery Procedure
Leading maxillofacial surgeons today use virtual surgical planning and 3D printing technology to predict and refine your outcome. You can decide the exact contours you want before going under the knife.
During the procedure, your surgeon makes an incision in your oral cavity, hiding any resulting scar. They then detach the masseter from the jawbone and disconnect the deeper fibres in contact with the bone. The fibres are thinned down, muscle reattached, and they close the incision. The entire procedure takes about 20 minutes, with minimal downtime and a fast recovery.
If you need jawbone trimming (angle resection), your maxillofacial surgeon in Delhi does this through the same oral cavity incision. Although conventional methods involved a neck incision, modern surgeons worry about avoiding the neck skin scar and injuring the marginal mandibular nerve in the neck. This nerve is responsible for a host of lower jaw functions, its injury presenting a massive functional deficit.
However, with virtual surgical planning, expert maxillofacial surgeons ensure precision in accessing the masseter and jawbone safely from inside the mouth. Then, using 3D printing technology, your surgeon prints out a guide for your jawline. They then use state-of-the-art piezosurgery (ultrasonic bone surgery) technology to shave down and shape the jawbone into a smaller, aesthetic shape. The guide and piezotome device offer unprecedented precision for a much safer and scarless experience.
Recovery After Masseter Hypertrophy Reduction Surgery
After your surgery, you will see some swelling and reduced mouth opening for 7-10 days, which continues to subside during this time.. You will need to avoid solid foods and heavy exercise for a week, too. However, as long as you follow your surgeon’s instructions and maintain good oral hygiene with regular saline washes, you should have no complications.
Your results become apparent within 3-4 weeks, and most of the swelling goes away within a month, after which the change in your facial shape and symmetry is entirely obvious. As long as your surgeon has access to the latest technologies discussed above, patient satisfaction and happiness are guaranteed, with a better outcome and faster recovery from a minimally invasive procedure.
As an expert maxillofacial surgeon in Delhi, Dr Sanchaita Kohli ensures that your masseter hypertrophy treatment at RG Aesthetics is an effective and long-term solution. She uses all the latest equipment in 3D visualisation and piezosurgery for natural-looking, precise results that ensure minimal trauma and entirely safe results!
Dr. Sanchaita Kohli
Oral and Maxillofacial Surgeon
Dr. Sanchaita Kohli is an Oral and Maxillofacial Surgeon with over 13 years of training and work experience at the country’s leading dental institute, Maulana Azad Institute of Dental Sciences, enabling her to plan and manage an extremely wide variety of craniofacial deformities, jaw diseases and facial trauma.