Masseter Muscle Disinsertion

Q: Dr. Eppley, I had standard Implantech jaw angle implants placed three years ago, and although they are an improvement they are not the desired result. They appear quite bulky and have accentuated an asymmetric appearance. Furthermore, my right masseter muscle is now partially torn creating a large bulge around my cheek bone when I eat. Is this common with this surgery? I am reaching out to you with some questions:

1) Can Custom implants be placed after the removal of the current implants and the current state of the masseter?

2) Can the masseter be repaired at the same time as removal and placement of new implants or will it need to be two separate operations?

3) Can the masseter be repaired through intraoral approach? If not, what level of scaring will be present from an external approach?

Many thanks for answering my questions.

A: Thank you for your inquiry. In answer to your jaw angle and masseter muscle disinsertion questions:

1) Custom jaw implants can be used as replacements for your existing standard implants.

2) Masseter muscle disinsertion is a very difficult problem to correct. Surgical correction could be attempted at the time of implant replacements, provided the new implants are not substantially bigger than the ones you have.

3) Attempted correction of masseter muscle disinsertion is best done through an external approach, using a 2.5 cm incision below the jaw angle. With a disinsertion that is five years ago I would not be optimistic that it is improveable.

Dr. Barry Eppley
Indianapolis, Indiana