Masseteric hypertrophy is a relative common clinical finding in the general population. It may be associated with a parafunctional habit or occurs as an idiopathic entity. Temporalis muscle hypertrophy is a rare clinical entity and only a few cases are reported. More often it presents a bilateral involvement and is usually associated with masseteric hypertrophy. The most reported treatment for temporalis muscle hypertrophy is by a conservative approach with the use the botulinum toxin A. It can be a non-invasive option to treat patients with muscle hypertrophy, but this therapy has showed a variable rate of recurrence and lack of long-term follow-up studies. A case of surgical treatment of bilateral temporalis and masseteric hypertrophy in an 18-year-old male is reported. Clinical features showed a marked bilateral swelling involving the temporalis and masseteric muscles. There was no pain during palpation or function. No bruxism, clenching or further parafunctional habits were identified and there were no relevant findings at medical history. Computer tomography and panoramic radiograph were utilized for diagnosis. Treatment was carried out by bilateral resection of the deep portion of the temporalis muscle through coronal approach and surgical recontouring of both mandibular angles with oscillatory saw through intra-oral approach. After six months of the surgical management the patient shows a harmonic facial appearance without evidence of depression, recurrence, dysfunction or asymmetry.

Conflict of interest: None declared.