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Related Concept Videos

Muscles for Facial Expressions01:14

Muscles for Facial Expressions

The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...

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Related Experiment Video

Updated: May 13, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
19:53

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Published on: March 1, 2015

Facial reanimation by staged, split masseter muscle transfer.

Malcolm A Lesavoy1, Kenneth L Fan, Andrew G Goldberg

  • 1From the *Division of Plastic and Reconstructive, David Geffen School of Medicine at UCLA, Los Angeles, CA; and †University of Miami, Miller School of Medicine, Miami, FL.

Annals of Plastic Surgery
|March 21, 2013
PubMed
Summary

This study presents a staged, split masseter transfer technique for lower facial paralysis. The method effectively restores subtle facial animation and improves symmetry in patients when other surgical options are unavailable.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Facial Nerve Surgery

Background:

  • Lower facial paralysis causes significant functional and aesthetic issues.
  • Regional muscle transfer is a key surgical option when nerve repair or free functional muscle transfer is not feasible.
  • Previous masseter transfers had limitations due to orbicularis oris attachment issues.

Observation:

  • A staged, split masseter muscle transfer using fascia lata grafts was performed.
  • The technique involves three stages: graft placement, muscle transfer, and reinforcement.
  • Six patients with lower facial paralysis were treated, with a mean age of 43 years.

Findings:

  • All patients demonstrated significant functional and aesthetic improvement.
  • Restored symmetry in repose and achieved mean commissure excursion of 6.67 mm on movement.
  • Five patients required minor revisions for optimal outcomes.

Implications:

  • The staged, split masseter transfer is a reliable method for lower facial reanimation.
  • This technique provides both static and dynamic function restoration.
  • Demonstrates excellent long-term functional results in a case series.