Masseter muscle reattachment after mandibular angle surgery

Aesthetic Surgery Journal
Mathew A Thomas, Michael J Yaremchuk

Abstract

Altering the dimensions of the mandibular angle by alloplastic augmentation or skeletal reduction requires elevation of the insertion of the masseter muscle, including the pterygomasseteric sling. Disruption of the pterygomasseteric sling during exposure of the inferior border of the mandible can cause the masseter muscle to retract superiorly, resulting in a loss of soft tissue volume over the angle of the mandible and a skeletonized appearance. Subsequent contraction of the masseter elevates the disinserted edge of the muscle and not only increases the skeletonized area, but also exaggerates the deficiency by causing a soft tissue bulge above it. The authors describe the disinsertion of the masseter and the resulting deformity as a potential complication of mandibular angle surgery and review the technique for repair. The records of 60 patients (44 primary, 16 secondary) who presented for alloplastic mandible augmentation between 2003 and 2008 were reviewed. Nine patients presented with clinical signs of disruption of the pterygomasseteric sling after mandibular angle surgery. Five patients had clinical signs consistent with complete disruption. Two of these patients requested reconstruction. The other four had signs consiste...Continue Reading

Citations

Jun 27, 2013·Current Opinion in Otolaryngology & Head and Neck Surgery·Michael G Brandt, Corey C Moore
Feb 19, 2016·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Maurice Y Mommaerts
Dec 13, 2018·Annals of Plastic Surgery·Xi FuYing Chen
Apr 23, 2021·Aesthetic Surgery Journal·David M Straughan, Michael J Yaremchuk

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