Controversies in Contemporary Facial Reanimation

• Published in: Facial plastic surgery clinics of North America Vol. 24; no. 3; pp. 275 - 297
• Main Authors: Kim, Leslie, MD, MPH, Byrne, Patrick J., MD, MBA
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2016
• Subjects: Dynamic reanimation; Facial Expression; Facial palsy; Facial paralysis; Facial Paralysis - diagnosis; Facial Paralysis - surgery; Facial reanimation; Free gracilis muscle transfer; Humans; Muscle, Skeletal - innervation; Muscle, Skeletal - transplantation; Nerve Transfer - methods; Nerve transfers; Plastic Surgery; Reconstructive Surgical Procedures - methods; Severity of Illness Index; Surgical Flaps - innervation; Surgical Flaps - transplantation; Dynamic reanimation; Free gracilis muscle transfer; Facial reanimation; Facial palsy; Nerve transfers; Facial paralysis
• ISSN: 1064-7406; 1558-1926
• DOI: 10.1016/j.fsc.2016.03.016

Facial palsy is a devastating condition with profound functional, aesthetic, and psychosocial implications. Although the complexity of facial expression and intricate synergy of facial mimetic muscles are difficult to restore, the goal of management is to reestablish facial symmetry and movement. Facial reanimation surgery requires an individualized treatment approach based on the cause, pattern, and duration of facial palsy while considering patient age, comorbidities, motivation, and goals. Contemporary reconstructive options include a spectrum of static and dynamic procedures. Controversies in the evaluation of patients with facial palsy, timing of intervention, and management decisions for dynamic smile reanimation are discussed.