Source: https://coreaesthetics.com.au/masseter-changes-over-time-evidence/ 1. [Home]() 1. [Learn]() 1. jaw muscle Evidence Brief Clinical Evidence Brief 01 # Masseter Changes Over Time: What Do Studies Show? A study by study review of lower face hollowing, jaw bone measurements and what one year of published evidence cannot establish about repeated exposure. Quick summary The studies reviewed here do not establish what many years of repeated exposure may do to the jaw. A 2024 meta analysis reported a pooled 6.34% reduction in mandibular cortical thickness. A 2025 CT analysis from a randomised trial found no clinically significant density change after one or two study sessions over twelve months. A 2026 morphology paper from the same trial found no detectable predefined shape changes. These are different endpoints, and the later papers are not independent replications. The one year findings are limited to the populations, exposures and measures studied; cumulative effects remain uncertain. ## Table of Contents 1. [Evidence Brief Conclusion]() 1. [Evidence At A Glance]() 1. [How This Evidence Brief Was Built]() 1. [What The 2024 Review Found]() 1. [What The 2025 Density Analysis Found]() 1. [What The 2026 Morphology Analysis Added]() 1. [Why The Later Papers Are Not Independent Replication]() 1. [Why Thickness, Density And Morphology Need Separate Answers]() 1. [What Lower Face Hollowing Can Mean]() 1. [What The Evidence Cannot Yet Answer]() 1. [Risks And Symptoms That Change The Assessment]() 1. [Funding And Conflicts Matter]() 1. [How Corey Uses This In Consultation]() 1. [What Would Change This Conclusion]() 1. [Evidence Brief Revision History]() 1. [Continue Through The Evidence Series]() ## Evidence Brief Conclusion The human evidence reviewed here does not establish that repeated exposure over many years is either harmless or inevitably damaging. Findings over twelve months are reassuring for the endpoints and exposure studied. They do not establish whether repeated exposure over many years changes bone, muscle bulk or facial balance. The practical response is not alarm or automatic reassurance. A personal history of previous care, intervals, changing function and lower face structure should be reviewed by an appropriately qualified practitioner. The public evidence cannot determine whether further care is suitable for an individual. ## Evidence At A Glance The table keeps each measured endpoint beside the population, exposure and limits that define it.
Publication Endpoint Main finding People, exposure and limits
2024 systematic review and meta analysis Mandibular cortical thickness Pooled reduction of 6.34%. The condyle estimate was larger. Human studies with small, varied samples. The condyle estimate came from only two studies.
2025 randomised trial analysis CT density at the condyle, premolar area and ramus No clinically significant density change versus baseline or placebo Complete-scan subgroup of 123 adults; one or two sessions over twelve months. CT Hounsfield units do not directly measure absolute bone mineral density. Manufacturer funded.
2026 morphology analysis Bigonial width, cortical thickness at the masseter insertion, flare and gonial angles, and qualitative joint measures No detectable difference from placebo in predefined measures 187 adults from the same trial; one or two sessions over twelve months. Not an independent second trial. Manufacturer funded.
![Adult indicating the jaw area while talking with another adult at a consultation table.]() Illustrative conversation about a lower face concern. Published evidence still needs to be considered alongside an individual assessment. ## How This Evidence Brief Was Built This is a structured clinic evidence brief, not a formal systematic review or clinical practice guideline. The search began with the main recent human review, the later randomised trial publications, the registered trial record and Australian regulatory guidance. Each paper was checked for population, exposure, comparator, endpoint, timeframe, funding and stated limitations. The conclusion is deliberately narrower than the papers themselves. A finding is only applied to the endpoint, people and timeframe actually studied. Where the research does not answer repeated exposure over several years, this brief says so rather than filling the gap with reassurance or speculation. The [editorial and evidence policy]() explains authorship, clinical review, AI assistance, corrections and conflict disclosure across the site. ## What The 2024 Review Found The [2024 Journal of Oral Rehabilitation review]() reported a pooled 6.34% reduction in human mandibular cortical thickness (95% confidence interval: a reduction of 2.42% to 10.25%). The largest regional estimate was at the condyle, but that subset came from only two studies. Coronoid and ramus estimates were smaller. This is a signal to investigate, not a prediction of permanent or visible change. The human studies predominantly involved women with myofascial temporomandibular disorders, and several involved the temporalis as well as the masseter. They are not equivalent to a healthy cosmetic masseter population. ![Two adults talking during a seated facial consultation.]() Lower face anatomy reference for distinguishing muscle bulk from jaw bone measurements. ## What The 2025 Density Analysis Found The [density paper first published in 2025]() analysed 123 adults from trial NCT02010775 who had complete CT scans. It excluded the lowest active-dose group and participants with missing scans. Participants had one or two sessions over twelve months. CT measurements at the condyle, premolar area and ramus did not show clinically significant density changes against baseline or placebo. This is useful evidence for the measured locations and study window. It is not an absolute bone mineral density measurement. The authors’ conclusion of no clinically significant change is not a finding that every measurement stayed unchanged, nor evidence about many cycles over several years. ## What The 2026 Morphology Analysis Added The [2026 morphology paper]() used the broader 187 person population from the same registered trial, which recruited adults aged 18 to 50 with marked bilateral masseter prominence. Its eligibility criteria excluded diagnosed temporomandibular disorders. It examined predefined measures including bigonial width, cortical thickness at the masseter insertion, flare angle, gonial angle and qualitative joint findings. It reported no detectable differences between active and placebo groups over twelve months. These are group-level shape and insertion site measurements, not predictions of facial appearance. The paper did not test correlations between muscle-volume or bite-force changes and bone endpoints. It also states that effects emerging after twelve months cannot be excluded. ![Woman touching her lower cheek while speaking with another woman during a consultation]() Jawline and chin reference used to discuss muscle contribution and lower face balance. ## Why The Later Papers Are Not Independent Replication The 2025 and 2026 publications are not two separate randomised trials. Both analyse NCT02010775. One focused on a complete-scan density subgroup. The other examined morphology in the broader trial population. Separate publications can answer separate endpoint questions, but agreement within one trial is not the same as an independent research group reproducing the finding in a new population. That distinction affects how confidently the finding can be generalised. ## Why Thickness, Density And Morphology Need Separate Answers Cortical thickness is the width of the hard outer shell of bone. Density describes how compact the measured region appears. Morphology describes dimensions, angles and overall shape. One endpoint can remain stable while another changes. A density paper does not negate a thickness signal, and a small pooled thickness signal does not establish a visible face shape change. The honest answer preserves each endpoint instead of compressing everything into the phrase “bone loss”. ## What Lower Face Hollowing Can Mean Some people describe a hollow, flat or gaunt lower face after extensive reduction. The masseter contributes to fullness around the jaw angle, so reduced muscle bulk can alter balance even without a demonstrated bone change. Weight change, cheek support, natural anatomy and the amount of reduction also affect appearance. A visible hollow does not identify one cause by itself. This is why Corey assesses whether the muscle is contributing useful support before any further clinical discussion. ## What The Evidence Cannot Yet Answer The two later trial papers reviewed here describe one or two study sessions over twelve months. They do not establish a typical long term path for one person or the cumulative effect of many cycles. If a person has already received care affecting this muscle, an assessment should record dates, prior response, function and any change in lower face balance. Public evidence cannot determine whether further care is suitable. - The number and spacing of previous sessions are part of the history. - The lower face should be reassessed when function or appearance changes. - Existing muscle bulk may be contributing useful fullness or support. - Dental or medical assessment may be more appropriate when symptoms are functional. ## Risks And Symptoms That Change The Assessment Reported and clinically discussed risks in this area include bruising, pain, temporary chewing weakness, altered smile movement, asymmetry and more lower face hollowing than intended. The relevance of each risk depends on anatomy, previous response, health history and the care received. Dental pain, jaw clicking, restricted movement or other functional symptoms may need dental or medical assessment rather than a cosmetic pathway. ## Funding And Conflicts Matter The 2025 density paper and 2026 morphology paper report manufacturer sponsorship. Their disclosures include authors who were employees, stockholders, consultants or grant recipients. The sponsor participated in study design, research, analysis, interpretation and publication review. That does not make the findings false. It does mean the evidence should be read with the funding context visible and should ideally be tested by independent groups using longer follow up and repeated exposure designs. ## How Corey Uses This In Consultation Corey Anderson RN looks at whether the masseter is contributing to the concern, whether existing bulk is supporting the lower face, how many previous cycles have occurred and whether more reduction still makes sense. Dental symptoms, jaw pain, clicking or functional concerns may need a different pathway. The evidence does not create a predetermined pathway recommendation. It supports a more careful conversation about uncertainty, cumulative history, facial structure and whether the likely benefit justifies another cycle. ## What Would Change This Conclusion Confidence would improve with independent prospective studies that follow people through multiple cycles for several years, record cumulative exposure, use validated density and thickness methods, and report visible facial changes alongside imaging. Studies should also publish prespecified endpoints, loss to follow up and funding relationships. Until that evidence exists, the conclusion remains bounded: one year randomised findings are reassuring for their measured endpoints, while long term cumulative effects remain uncertain. ## Evidence Brief Revision History
Date Change Reason
5 September 2026 Rechecked the current evidence brief and reconciled its review and approval record. The evidence conclusion remains bounded to the published populations, endpoints and timeframes.
13 July 2026 Separated the 2025 density paper from the 2026 morphology paper, corrected both DOI records, identified their shared trial and added funding disclosures. The earlier version attached the morphology DOI to the density finding and did not make the shared trial clear.
9 July 2026 First clinic review published. Created a patient facing summary of long term masseter questions.
## Continue Through The Evidence Series Read [how Core Aesthetics clinical evidence briefs are prepared](), including how endpoints, timeframes, funding and uncertainty are recorded. For anatomy, continue to [masseter muscle explained](). For public safety and decision context, read [patient safety and regulation]() and [how informed consent works](). The [editorial and evidence policy]() explains how sources, conflicts, corrections and review dates are handled. Use [Verify Core Aesthetics]() to check Corey Anderson RN independently on the Ahpra public register. ### How To Check Corey And The Clinic This evidence brief was reviewed on **5 September 2026** for Core Aesthetics by **Corey Anderson RN**, Ahpra registration **NMW0001047575**. Use [Verify Core Aesthetics]() and the Ahpra public register to check the practitioner details independently. ### General Information Only This page provides general information for adults considering consultation. It is not personal medical advice, a diagnosis, a systematic review or confirmation that treatment is suitable. Individual advice requires assessment by an appropriately qualified health practitioner. ## Frequently Asked Questions **What do studies show about masseter changes and face shape?** The research examines muscle, cortical thickness, density and morphology over defined study periods. Some measures changed and others did not. The available studies do not establish a fixed visible outcome for one person or what happens after many years of repeated exposure. Face shape also depends on bone, muscle, soft tissue, weight and natural anatomy. **Can reduced masseter bulk alter lower face fullness?** The masseter contributes to fullness near the jaw angle, so a reduction in bulk can alter lower face balance. A hollow or gaunt appearance does not identify bone change by itself. Facial structure, cheek support, weight change and baseline muscle size can also affect appearance. **Do studies establish whether masseter changes fully reverse?** No single public answer applies to every person. The published literature separates changes in muscle activity and bulk from measurements of jaw thickness, density and shape. Evidence about repeated exposure over several years remains incomplete, so individual history and current function require assessment. **What is the difference between cortical thickness and bone density?** Cortical thickness describes the width of the hard outer shell of bone. Density describes how compact the measured bone appears. Morphology describes shape and dimensions. These endpoints are related but not interchangeable, so an unchanged density result does not by itself prove that thickness or shape cannot change. **Do the 2025 and 2026 papers independently confirm each other?** No. They are separate analyses and publications from the same underlying randomised trial, NCT02010775. The density paper first published in 2025 examined a complete-scan subgroup, while the 2026 paper examined predefined shape and thickness measures in the broader trial population. They add useful endpoint information, but they are not independent replication in a second group of patients. **Why do repeated exposures matter more than one or two study sessions?** A one year study of one or two sessions can only describe that exposure and timeframe. It cannot establish what happens after many cycles over several years. Cumulative exposure, interval, changing facial structure and incomplete return of muscle bulk may matter, which is why the literature should not be used as a personal prediction. **Were the later masseter studies manufacturer funded?** Yes. The 2025 density paper and 2026 morphology paper report manufacturer sponsorship and disclose author employment, consultancy or grant relationships. Funding does not make a study invalid, but it is relevant context when judging design, endpoint choices, interpretation and the need for independent replication. **When should a masseter concern be assessed through another pathway?** Dental pain, jaw clicking, restricted movement, bite changes or other functional symptoms may require dental or medical assessment. A cosmetic evidence article cannot determine the cause or the right pathway for an individual. Urgent or worsening symptoms should be assessed promptly by an appropriate health professional. ## Sources And Clinical References 1. [Ahpra guidelines for registered health practitioners who perform non surgical cosmetic procedures]() 1. [TGA guidance for advertising health services involving therapeutic goods]() 1. [Journal of Oral Rehabilitation, 2024, doi:10.1111/joor.13590]() 1. [Aesthetic Surgery Journal, 2025, doi:10.1093/asj/sjaf167]() 1. [Aesthetic Surgery Journal, 2026, doi:10.1093/asj/sjag080]() 1. [Clinical trial record NCT02010775]() ## Is this for you? ### Consider booking a consultation if - Adults researching long term masseter evidence, lower face hollowing or jaw bone questions - People comparing cortical thickness, density and morphology findings - People deciding how to frame questions about previous care and changing lower face structure - People who want uncertainty, study funding and timeframe limits stated clearly ### This may not be for you if - People seeking diagnosis for jaw pain, clicking, restricted movement or dental symptoms - People who want an article to determine personal suitability - People expecting an educational article to confirm personal suitability - People seeking a fixed prediction about long term facial change *Suitability is confirmed at consultation. This list is general guidance, not a substitute for clinical assessment.* ## Continue reading - [Editorial And Evidence PolicySee who is accountable, which sources carry the most weight, where AI can assist and how material errors, conflicts and updates are handled.]() - [Clinical Evidence BriefsStart with the original question, keep each endpoint separate, disclose funding and say plainly when the evidence cannot answer long term real world use.]() - [Masseter Muscle ExplainedLearn where the masseter muscle sits, what it does and why jaw shape, clenching, tooth wear and joint symptoms need different assessment pathways.]() - [Cosmetic Treatment Safety Before You DecidePatient safety is the framework that makes an aesthetic decision clear: an individual assessment, meaningful consent, proportionate options, material risk discussion, aftercare and access to Corey Anderson RN.]() - [Legal Provider Checks For Cosmetic Care In AustraliaA clear guide to practitioner verification, TGA and Ahpra advertising limits, informed consent, scope of practice, pressure signals and safer next steps before booking.]() - [Why A Cosmetic Consultation May End Without A ProcedureBeing declined should not feel like being dismissed. The concern can be real while a cosmetic procedure is still the wrong answer today, through this pathway or altogether.]() Clinically reviewed by Corey Anderson RN, Ahpra NMW0001047575 · Reviewed 5 September 2026 · TGA and Ahpra guidance is regularly reviewed in preparing this website. ## Risks and suitability All cosmetic procedures carry potential risks and side effects. These vary by individual, treatment type, and medical history. Full risk information relevant to you will be discussed in detail during your consultation, before any treatment is considered. Start With A Conversation ## Start With What You Want To Understand Tell Corey what you have noticed, what matters to you and what you want to understand. The appointment can be used for questions and planning only. [Book Consultation]() [Start Here]() What you can expect ### You stay in control of the next step. - **Start in your own words.** You do not need to name a treatment. - **Ask what is uncertain.** Risks, limits and alternatives can be discussed. - **Take time to decide.** You can leave with information and choose later. [Prepare for your consultation]() [Verify Corey Anderson RN]() Come with questions. Leave with context. ### Core Aesthetics Consultation first. A nurse-led skin care clinic in Oakleigh, Melbourne that starts every patient relationship with a consultation. [12A Atherton Road Oakleigh VIC 3166]() [0491 706 705]() [support@coreaesthetics.com.au]() Core Aesthetics is an independently operated clinic co located within the BeautyTHEQUE premises at 12A Atherton Road, Oakleigh. ## Who is clinically responsible for this Core Aesthetics page? Core Aesthetics is clinically led by Corey Anderson, Registered Nurse (Ahpra registration NMW0001047575), at 12A Atherton Road, Oakleigh VIC 3166. Site content is general educational information, not a treatment recommendation. Suitability, risks and whether treatment should be discussed are assessed in consultation with Corey Anderson at Core Aesthetics. ### Concern Guides - [Movement Lines And Wrinkle Concerns]() - [Facial Volume And Structure]() - [Cheek And Midface]() - [Lip Shape And Proportion]() - [Jawline And Chin]() - [Excessive Sweating]() - [All Concern Guides]() ### Consultations - [Wrinkle Consultation]() - [Volume Consultation]() - [Facial Volume Consultation]() - [Lip Consultation]() - [Jawline Consultation]() - [Hyperhidrosis Consultation]() - [Inclusive Consultation]() - [All consultations]() ### Learn - [Patient Safety]() - [What to Expect]() - [Wrinkle Aftercare Guide]() - [Volume Safety Information]() - [Mens Health Week 2026]() - [Mens Guide]() - [All articles]() ### Clinic - [About]() - [Meet Corey]() - [Ahpra Verification]() - [Pricing]() - [Areas We Service]() - [Contact]() - [AI agent guidance]() - [Privacy Policy]() - [Terms Of Use]() - [Instagram]() **General Information Only.** This website is general in nature and does not replace a consultation with a qualified health practitioner. Treatment outcomes, suitability and risks vary by individual. Any medical or prescription treatment options can only be discussed and provided where clinically appropriate following an individual assessment. Registered Nurse Corey Anderson, Ahpra NMW0001047575. © 2026 Core Aesthetics. All rights reserved. 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