What is a permanent cure for masseter hypertrophy?

Question

I have TMJ caused by masseter hypertrophy and for the past several years have been treated using botox, and have recently tried dysport and Xeomen. These treatments are expensive and I have begun to require more frequent treatments along with larger doses in order to treat the problem. I would like the problem solved permanently. Is there a surgical solution to masseter hypertrophy? Radio Frequency? I have had physical therapy for TMJ and do not chew gum, engage in any other bad habits..

Ira Shapira, DDS · Answer

FREQUENTLY MASSETER HYPERTROPHY IS RELATED TO BRUXISM  SLEEP APNEA.IS THE MASSETER HYPERTROPHY A COSMETIC ISSUE OR A PAIN ISSUE.  IF THE EAHAVIOR, OVER USE IS NOT CORRECTED THE PROBLEM CAN RECUR.  THERE ARE MULTIPLE MUSCLES INVOLVED IN CLENCH, THE MEDIAL PTERYGOID IN PARTICULAR.  SURGERY CAN CREATE IMBALANCES.  Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Past Chair, Alliance of TMD Organizations
Diplomat,  Academy of Integrative Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional SciencesMember, Academy of Cosmetic Dentistry

Tanveer Janjua, MD · Answer

Masseter muscle can be cut surgically to reduce its bulk. However, it is an invasive surgery and despite the surgery your TMJ pain might not get better. You can try TMJ injections and may be a night time muscle relaxant.

	Regards

	Dr. J

	Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Michael I. Echavez, MD · Answer

I am not aware of any permanent cure for masseter hypertrophy, other than stopping any habits that might be the cause of it. If you haven't already, I would recommend seeing an oral surgeon to see if there might be any options for you.

Mireille Chae, MD · Answer

Sounds like you've been doing your research.  The surgical solution for masseter hypertrophy is to cut out a portion of the masseter muscle with or without reduction of any thickened underlying bone.  Yes, there are reports of radiofrequency used to to reduce hypertrophied masseter muscles.  Radio frequency appears to induce coagulation tissue necrosis of the masseter muscle.  If you are interested in radio frequency, you would need to find someone who offers this treatment, which appears to be less invasive.

	(This answer is not intended nor implied to be a substitute for medical advice.  It is posted for patients’ general education only.  Always seek the advice of your physician or other qualified healthcare provider for further evaluation of your individual case.)

David Alessi, MD - Account Suspended · Answer

Masseter hypertrophy causing TMJ is not treated the same as prominent jawline problems.  For aesthetic treatments, Botox or similar agents, radiofrequency, or jaw shaving can be done.  When masseter hypertrophy is associated with TMJ, Botox is the best way to go.  RF can reduce the size of the muscle but causing scar contracture which may worsen your TMJ.  Selective nerve resection can be done but usually requires and external incision.  Removing part of the muscle is possible, but you would be need to be committed to jaw physical therapy after.

	Best wishes.

What is a permanent cure for masseter hypertrophy?

Answers (5)