temporalis and masseter muscle atrophy

Within about 8 or 10 months, my temporalis and masster muscles on both sides of my face wasted away significantly. It left me with protruding cheekbones and hollow temples. The change has been very dramatic and noticeable to all who know me.

During the time that this happened, I had pretty serious TMJ problems. A disk in my left TMJ became displaced, my jaw was in a closed lock for almost a year and I was diagnosed with TMJ internal derangement and osteoarthritis. Muscle spasms and pain were very common in the beginning but have since subsided.

My health is otherwise good. I have not lost any weight whatsoever to explain the wasting. The muscle wasting became very apparent at age 27-28 and came about so quickly that this cannot be normal aging

I received treatment (splint therapy) for my TMJ issues 5 months ago and have regained almost full range of motion in my jaw. But I have not regained the lost muscle mass and still have major hollowness in the temples and cheeks. My TMJ specialist has no answers for me but he suggested that perhaps the muscles were hypertrophied to begin with and have now shrunk down to their regular size. This suggestion doesn't sit well with me as I now have dents in the sides of my head and in my cheeks which in no way look normal.  

What could explain this? Could it be connected to my TMJ problems or is it something else entirely? It has been 1.5 years since my TMJ problem crept up and about 8 months since the atrophy became apparent. I have been patiently waiting for it to resolve, but it hasn't yet. How much longer should I wait before seeing a new specialist?

[Nassim Abi Chahine, MD]

are you a heavy caffein drinker?

[jbloomfield]

Yes, I definitely was up until 5 months ago! I have cut back to one cup of coffee per day on the advice of my TMJ specialist. Prior to that I would have several (5-6 cups) a day because I always felt tired. Could caffeine consumption help explain this?

[Nassim Abi Chahine, MD]

really yes, but i don't understand why your muscles are not gaining weight.. do you have bruxism, or you clench to much, that could be a sign of depression!