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Updated: Sep 27, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Facial Paralysis, Modification to Labbé Technique
J M García Y Sánchez1,2, J A Reynaga Martínez3, C L Gómez Rodríguez4
1Maxillofacial Surgery, National Medical Center Century XXI, Specialty Hospital "Dr. Bernardo Sepúlveda, Mexican Institute of Social Security (IMSS), México City, Mexico.
Background:
Facial paralysis is one of the conditions that affect functionally, emotionally and aesthetically to patients greatly. Multiple techniques have been described for its treatment, and we consider that Labbé's technique is the one that most surprises with its results.
Materials And Methods:
In the Specialty Hospital "Dr. Bernardo Sepúlveda" National Medical Center Century XXI (CMN SXXI), Mexican Institute of Social Security (IMSS), three cases are presented: patients with facial paralysis due to trauma, surgical damage on the VII cranial nerve and conditions due to otological and idiopathic infections. Four modifications to the original Labbé technique are proposed to execute it more easily: trans-zygomatic oblique osteotomy, to reach directly the coronoid process; osteotomy of the descending coronoid; radiated suture fixation at 180° for temporary muscle replacement with positional replacement of the sutures trans-operatively; and the next day of the intervention with the patient awake, fixation of the orbicularis muscle of the lips, to the temporal tendon previously referenced. The modifications and results obtained are shown.
Results:
The modifications offer a better surgical technique and very favorable results.
Conclusions:
The modification to Labbé technique gives excellent results in the treatment of permanent facial paralysis, improving facial symmetry, salivary incontinence, facial tone, improving speech, giving the patient movement on the affected side and the ability to smile again.

