How Can I Reduce My Masseter Muscles Surgically?

Q: Dr. Eppley, Hi there I’m looking for a procedure to get a more narrow jaw. I used to get it with Botox. It treated the asywmetry as well as the wideness. But not I developed resistance. Neither Dysport or Xeomin or other brands worked. What are my surgical options?

A: Thank you for your inquiry and sending your pictures. It appears you are seeking jaw angle reduction, which has been proven by your injection history of having come from muscle enlargement. The best method for permanent masseter muscle reduction is non-surgical radio requency ablation, but that is not a procedure that is offered in the United States nor have I ever performed it. It is very effectively performed in Asian countries where massive muscle enlargement is far more common.

The surgical approach I have done for masseter muscle reduction is intraoral ablation by electrocautery by elevating the muscle off of the bone. This provides the opportunity to treat the inner surface of the muscle by heat which will cause some loss of muscle fiber sand subsequent thickness. It is not quite as effective as Botox, but does have some proven effectiveness. In some patients, I also shave a little bit of the jaw angle bone to provide some additional reduction as well.

Dr. Barry Eppley

Plastic Surgeon