Ke He (何锞)
Deputy Director & Head of Skin & Laser Aesthetics · Attending Physician, Licensed Aesthetic Attending · Lead Physician of This Site
Assessment of clenching and grinding · the masseter as a cause of facial width · conservative injectable planning with scheduled review
Dr. Ke He is Deputy Director of the Plastic Surgery & Aesthetics Medical Center at Chongqing West District Hospital and head of its skin and laser aesthetic service — and she is the lead physician of this site. A core specialist formerly at the Plastic and Aesthetic Surgery Department of Xinqiao Hospital, affiliated with Army Medical University, she has worked on the clinical front line in skin laser and injectable aesthetics for more than 20 years, serving over ten thousand patients.
Her assessment starts with the habit rather than with the muscle, because the habit is what the muscle is a record of. She asks when the width was first noticed, whether the jaw feels tired in the evening, whether a dentist has mentioned wear on the back teeth, and whether the clenching happens by day or during sleep. She then feels the masseter at rest and under clench, compares the two sides, and allows for what the bone and the fat over it are contributing. Where the muscle is not the finding she says so and describes what would help instead. Where it is, she plans a conservative first course, sets a review, and tells the patient plainly that the change arrives over weeks rather than days, that chewing feels different for a period, and that the effect fades and the width returns unless the habit itself changes.
Clinical focus
Academic roles & achievements
The width may not be in the muscle
A wide lower face looks similar whether the cause is the masseter, the mandible beneath it or the fat over either, and only the first of the three answers to an injection. A patient who has treatment for a width that was never muscular has a course of visits, a period of chewing that feels different, and an appearance unchanged. The examination exists to establish which layer is responsible, and it frequently ends with the injection not being given.