Hypertrophy of masseter muscle is idiopathic in nature which means that it is a spontaneous disorder which arises without any known cause. Even though the cause is known, doctors associate it with a number of habits and conditions. For most people, masseter hypertrophy is a cosmetic concern, which causes asymmetry of the face. This asymmetry is also known as square face. The masseter muscle is crucial for the chewing process and it lies laterally to Mandibular ramus. A masseter muscle which is hypertrophied produces changes in the facial lines, causes discomfort and negatively affects the appearance of a face. Instead of a square face, a round face or oval shaped face is more desired. It also hampers function of the muscle which may lead to conditions such as protrusion, trismus and bruxism. The actual cause is still unknown, however doctors have associated masseter hypertrophy to excessive chewing of gum, temporomandibular joint disorders etc. This condition can occur in anyone irrespective of age or gender etc. This may occur on one or both sides of the face.
Patients with masseter hypertrophy have widened mid and lower face. The widening of face or the square shape of face can be corrected if it is due to masseter hypertrophy. The correction can be done with Botulinum toxin injection which is also known as Botox. The Botox injection treatment softens the angles of the jaw and gives the face a more pleasing shape. This procedure with Botulinum toxin injection is an out-patient procedure. The use of Botox discards the need of any unwanted and complicated surgery. The patient’s face is examined and he is asked to bite the cheek. If the outer jaw line near the ears feels very hard upon biting, the masseter muscle may have hypertrophy. Thereafter the surgeon localizes the hypertrophied masseter muscle. After locating the affected masseter muscle, the surgeon holds the posterior and anterior muscle and injects the Botox injection in to the protruding muscle. Several techniques may be utilized to inject the patient. However, for the most optimized result and to eliminate any unwanted injections, the Botulinum toxin injection should only be given in the affected area. The results of the Botox procedure are seen within two weeks and the full results are seen within six weeks. The procedure does not take up a lot of time and both the sides of the jaw require only two to three injections. The procedure causes minimal or no pain. The slimming of the face and the reduction in the jaw line can be seen within four weeks. When the Botulinum toxin injection is injected in to the affected area it causes the muscle to relax. This leads to the muscle being redundant which leads to it being used less. The underused muscle reduces in size on its own due to loss in its mass. Generally, there are no after effects of Botox. Some people may notice that some tiring in the muscle if they chew the food fast. However, this is only temporary. One of the additional advantages of the Botox procedure is that the jaw line does not sag after the procedure. The procedure does not make the patient dependent on it. Neither it makes the masseter muscles immune to Botox or to any other form of treatment. If a patient wishes to discontinue he/she can discontinue at any moment. If a person does wish to stop the treatment, it will be noticed that in sometime the jaw muscles return to their original position, the way the muscle used to be before the treatment was done. Much like any other muscle, if the masseter muscle is worked by excessive chewing, it grows in size. The Botox procedure does not cause any major pain. The results for reduction of masseter muscle become evident in about two weeks and the results typically last for about 6 months to a year. The full results come about in two months but that depends upon the thickness of the masseter muscle. The surgeon performing the treatment will decide how much Botox the patient needs, the duration of treatment cycle and also when the patient should come for the follow up treatment. The amount of Botox needed depends and varies from one patient to another. Generally, for each side for complete treatment 20-40 units may be required. To avoid causing any major side effects due to Botulinum toxin, the surgeon may inject small cycles of Botox at small intervals during a prescribed treatment cycle. In most cases, there are no side effects after the treatment is done. However, like any medical procedure, there are some side effects and risks but they are quite rare. Some side effects may include adverse changes in smile, bruising, flu like symptoms etc. The clients may need touch up treatments after every 6 months.