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Updated: Jul 5, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Dynamic muscle transfer in facial reanimation
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Dynamic muscle transfers help restore facial symmetry and movement, particularly for long-standing paralysis. These techniques offer alternatives to free tissue transfer, each with unique benefits and drawbacks for facial reanimation.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Facial Reanimation
Background:
- Dynamic muscle transfers aim to improve facial support and symmetry with volitional movement.
- Commonly used for oral commissure reanimation to restore a smile.
- Also effective in reestablishing eye closure.
Purpose of the Study:
- To discuss dynamic muscle transfers for facial paralysis.
- To compare dynamic muscle transfers with free tissue transfer.
- To highlight challenges in managing long-standing facial paralysis.
Main Methods:
- Review of dynamic muscle transfer techniques for facial reanimation.
- Comparison of advantages and disadvantages of muscle transfers versus free tissue transfer.
- Focus on application in long-standing facial paralysis.
Main Results:
- Dynamic muscle transfers provide volitional movement for facial support and symmetry.
- Successful reanimation of oral commissure (smile) and eye closure is achievable.
- Long-standing facial paralysis presents distinct challenges managed by these techniques.
Conclusions:
- Dynamic muscle transfers are a key option for facial reanimation, especially in chronic cases.
- Both muscle transfers and free tissue transfer have distinct pros and cons.
- Management strategies differ significantly between early and late-onset facial paralysis.
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