Related Experiment Video
Updated: May 24, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Novel outpatient approach to lower lip reanimation using a palmaris longus tendon sling
Ashlin J Alexander1, John R de Almeida, Mark G Shrime
1Department of Otolaryngology–Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON.
Objective:
To report a new approach to lower lip reanimation, which can be performed in the outpatient clinic setting.
Study Design:
Cross-sectional study.
Setting:
Tertiary and quaternary care academic hospital, Toronto.
Subjects And Methods:
An evaluation of nine patients with marginal mandibular nerve injury, who underwent harvest of the palmaris longus tendon and static suspension of the lower lip, was performed in the outpatient setting. Outcome measures included subjective self-evaluation of the functional and aesthetic results using the Lip Reanimation Outcomes Questionnaire and postoperative photographic grading of symmetry at rest and during three smile poses. Medical records were reviewed for demographics and complications.
Results:
Seventy-eight percent of patients reported overall improvements in smiling, oral competence, and speech articulation following tendon transfer. Photographic grading by the judging panel found satisfactory smile symmetry postprocedure.
Conclusions:
The palmaris longus tendon sling procedure provides an effective, additional option for reanimation of the paralyzed lower lip.
