Related Experiment Video
Updated: May 13, 2026
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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
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.
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.
