Massetter Muscle Reduction (Surgical and Non-Surgical)
What is the massetter muscle?
The massetter muscle runs through the rear part of the cheek, from the cheek bone down to the lower jaw on each side of the face. It is known as one of the “muscles of mastication” and works to raise and close the jaw while chewing. The muscle connects the mandible (lower jawbone) to the cheekbone.
Why does the massetter muscle sometimes need to be reduced?
The massetter muscle can become enlarged in people who have a tendency to clench or grind their teeth (bruxism) or who chew gum excessively. This may result in an asymmetry of the face due to unequal muscle enlargement and increased bulk of the massetter, potentially creating an overly-square jawline.
Typically women, or those seeking facial feminization, prefer a softer, smoother appearance to the jawline, and therefore seek to reduce the size of the massetter.
Reduction of the massetter muscle is also deemed as highly desirable by women with Asian ethnicity, specifically those of Korean ancestry. In this ethnic group, it is very common to reduce the massetter to make the face look less square and more almond-shaped. This procedure is sometimes known as Asian V-line surgery.
Reduction of the massetter may be performed by either 1) surgical, or 2) non-surgical methods.
1. Non-surgical reduction of the massetter muscle with Botox
Injectable muscle relaxing agents such as Botox or Dysport work extremely well to non-surgically reduce the massetter muscle. These types of injections reduce the size of the muscle and also decrease habitual jaw clenching or teeth grinding at night.
The procedure involves your surgeon injecting Botox directly into the massetter muscle in small doses over a series of sessions until the desired appearance is achieved.
However, since this is a more advanced use of Botox and Dysport, your plastic surgeon should be US Board Certified and also have a comprehensive and indepth understanding of craniofacial anatomy – otherwise unintended side effects may result.
After your initial treatment, the effects of Botox will be evident almost immediately as you will experience less muscle pain and less TMJ-related headaches. It will then take about six months before visible shrinkage of the massetter muscle is obvious.
Injections of Botox need to be repeated every 4-6 months for at least a year to see a significant reduction in the size of the massetter muscle. Depending on the individual, the decreased size of the masseter may stay intact – even without further injections of Botox.
Why might it be necessary to “revise” an injectable massetter muscle reduction treatment?
If your medical provider is unqualified and either Botox® or Dysport® are not injected into the massetter muscle correctly, serious negative side effects may result that may take months, or even years to resolve. Typically an unskilled provider may inject the Botox® or Dysport® into the wrong area, or too deep or too shallow into the muscle.
2. Surgical reduction of the massetter muscle
Depending on your natural facial features and your desired aesthetic outcome, you may require a more aggressive approach to reduction of the massetter; and a surgical option will be recommended.
Massetter reduction surgery is undertaken through incisions on the inside of the mouth, between the gum and cheek, to access the mandible (jawbone) leaving no visible scarring.
Your surgeon shapes and reduces the bone and massetter muscle to achieve a well-rounded, smoother and streamlined jawline contour. Once the correct amount of bone and muscle has been removed, the incision is closed with self-dissolving sutures.
Recovery time from surgery takes approximately 2 weeks. Initially 2-3 days after surgery, the face will be mildly swollen and bruised, however, the majority of swelling will decrease within 10 days.
The full results of your surgery will become evident within 4-6 weeks after surgery and improved jaw shape becomes visible.