Does Posterior Temporal Reduction Surgery Result In Any Long Term Functional Problems?

Q: Dr. Eppley, my issue is mainly the posterior part of the temporal muscle. I looked it up and it was stated online that the posterior muscle is responsible for moving the jaw forward and back. I have three questions:

1) Is it possible to remove 50% of the posterior muscle, cut it in half so that it goes from being 7mm to 3.5mm. I don’t want to use the word shave it down, but slice it down the middle. 

2.) Are there any complications at all even from removing a portion of the posterior muscle and not the whole thing? I’m not looking to have a flat side of the hea. I’d still like there to be some curve, I just think there’s a high risk if we go down the Botox route of the units shifting to other parts of the face.

3.) Would I be able to talk to a few other male patients who had this procedure, before I commit to having it. 

My main fear is having something permanent that causes functional problem because muscles do shrink with age. How will my temporal muscle fair up when I turn 80?

A: In answer to your posterior temporal reduction surgery questions:

1) Muscle is not like bone, there is no shaving of it particularly from a remote incisional access. As I said earlier a portion of the muscle can be removed through a release and rotational maneuver to keep some of the muscle thickness.

2) Regardless of what any anatomic textbooks say the entire posterior belly of the temporal muscle can be removed without any functional sequelae on mouth opening and closing. I would know after over 100 posterior temporal muscles removed and no patients has ever even had temporary mouth opening stiffness. That is because 70% of the temporal muscle lines anterior and the posterior part makes up a small percentage of the muscle despite its apparent large surface area coverage.

3) Botox does not shift to other parts of the face. It has a well known intramuscular diffusion range of only 1 to 1.5cms from the injection site.

Dr. Barry Eppley

Indianapolis, Indiana