Angle Osteoplasty and Cosmetic Debulking for Correction of a Case of Unilateral Masseteric Hypertrophy

Abstract

Facial asymmetry is one of the commonest causes of impaired aesthetics, serving as a strong motivation for patients to seek corrective treatment. Benign masseteric hypertrophy is a well-known, albeit uncommon condition of rather obscure etiology, resulting from unilateral or bilateral increase in volume and bulk of the masseter muscle, that may or may not be accompanied by hyperostosis of the underlying bony angle of the mandible. This report elaborates a modified surgical modality and operative technique that effectively addresses both, the hard as well as soft tissue malformations in the region simultaneously, and is associated with the least incidence of relapse and recurrence of the condition. A 26-year-old woman with severe facial asymmetry resulting from unilateral masseteric hypertrophy was taken up for surgical debulking of the masseter. Surgical resection of one-third of the hypertrophied muscle bulk from its inner or medial aspect, followed by shaving of bony spurs and recontouring of angle of the mandible, was done. The surgical technique described is a definitive, efficacious, and reliable intervention for successful and long-term management of idiopathic masseter muscle hypertrophy that results in an excellent and long-lasting aesthetic outcome.