How Successful Is Masseter Muscle Repair For Dehiscence From Implant Placement?

Q: Dr. Eppley, How can my masseter muscle dehiscence be fixed after a custom jawline implant was placed?

A: What you really have is a combination of both masseter muscle dehiscence and, most importantly, what is known as implant reveal. (an implant design issue) Your jawline implant design was destined to have this problem as it violates the anatomic boundary of the masseter muscle. When you make the angle design of the implant go too far posteriorly it will stick out beyond the muscle. While the masseter muscle can elongate vertically you can not increase its width. Thus jawline implant designs that attempt to square out the jaw angle (which is anatomically unnatural) will create an uncovered area of the implant.

The relevance is that you can’t make the muscle go where it has never been. (muscle dehiscence repair) All you can do is volumetrically add to the overlying soft tissue in a camouflage approach. Whether that is best done by fat injections, alloderm sheeting or soft tissue jaw angle implants can be debated.

Dr. Barry Eppley

World Renowned Plastic Surgeon