A new novel surgical technique for the management of asymmetric bilateral masseteric hypertrophy

Bilateral masseteric hypertrophy is a rare entity affecting the lower third of the face. An uncommon idiopathic condition is related to increased volume bulk of masseter muscles. Several treatment modalities are employed for its management and surgical and conservative treatments. Surgical treatment aims at angle ostectomy along with muscle debulking. The purpose of this case report is to present a new precise technique applied for the angle resection of the mandible along with muscle debulking. A 17-year-old female visited our Department of Oral and Maxillofacial Surgery with a major esthetic complaint of wide asymmetrical angles of the jaw associated with mild tenderness on palpation and occasional reduced mouth opening. To reduce the unpleasant lower facial third appearance, intraoral incisions were placed on both sides and bilateral angle resection was accomplished using a planned ostectomy using the fabricated splint for precise cuts. Patient satisfaction was achieved esthetically and functionally too. Six months of postoperative follow-up produced uneventful outcomes. Prominent square-shaped appearance of the lower face was precisely converted to an optimal oval face with the use of stereolithographic model fabrication and a surgical splint guide.