[Cube Plastic Surgery] Do You Really Need Masseter Reduction Surgery for Square Jaw Correction Surgery? - Explained by a Board-Certified Plastic Surgeon.

Hello, this is Director Hyunwoo Cho of Cube Plastic Surgery.

Today, I will talk about masseter resection surgery (masseter reduction surgery).

In general, when most patients visit the clinic and say that their face looks square,

the issue may sometimes be an especially developed mandibular angle, but in fact, when viewed from the front, a square face is greatly affected not only by bone but also by muscle and fat.

There are also many people who come in for revision square jaw surgery and, in fact, do not need the bone to be cut.

Even when performing cortical ostectomy, as mentioned in the previous column, many of the remaining concerns are related to muscle.

Let’s take a look at how to reduce this muscle.

The part inside the red circle in the illustration is the masseter muscle.

The masseter attaches from the lower jawbone toward the cheekbone, and it is the muscle that plays the biggest role in chewing.

As you can see on the CT scan, the masseter takes up a very large volume.

If you look at it while knowing that the cortical ostectomy explained last week is the blue area, you can see just how large the muscle volume is.

You can also see that it occupies a very large area in actual anatomical photos.

Therefore, no matter how much the square jaw bone is shaved and cortical ostectomy is performed, people with large muscles may have difficulty achieving a good frontal effect.

So how can we reduce the masseter muscle?

First, Botox is the most representative way to reduce muscle size.

However, with Botox, the muscle volume returns after 3 to 4 months, so many patients want a method that lasts a little longer.

Among these, there is also a lot of interest in muscle mid-frequency and radiofrequency procedures.

However, if you look at the content on each website, you will often see terms like semi-permanent or long-term rather than permanent.

The reason is that methods that paralyze the nerves of the muscle or burn the muscle often see their effect decrease after 6 months to 1 year, and recurrence is common.

These frequency-based treatments burn the muscle or block the nerves, but in the case of muscle, it is difficult to burn a lot of it, and the nerves often regenerate through branches, so recurrence is common.

Masseter resection surgery (masseter reduction surgery) does not recur because the masseter is permanently removed during mandibular angle surgery.

Because the muscle is removed, the pain is not severe, and since the procedure is performed while directly visualizing and precisely resecting it, there is little concern about bleeding.

It can be said to be a very safe surgery.

However, masseter resection surgery cannot be done in unlimited amounts.

That is because the masseter naturally decreases with age, and the reason older people have difficulty chewing well is that the masseter has decreased significantly.

Therefore, removing only about 10–15%, not enough to weaken the muscle with age, should still produce an effect of reducing the mandibular bulk from the front as well.

So far, we have looked at masseter resection surgery.

Of course, I think removing only the muscle without square jaw surgery is a bit excessive.

However, when performing square jaw surgery, combining it with masseter resection surgery can be a good option for improving the surgical result.

Thank you.