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Related Experiment Video

Updated: Sep 22, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Automated Spontaneity Assessment after Smile Reanimation: A Machine Learning Approach.

Joseph R Dusseldorp1, Diego L Guarin1, Martinus M van Veen1

  • 1From the Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary and Harvard Medical School; Department of Plastic and Reconstructive Surgery, Royal Australasian College of Surgeons and University of Sydney; and Department of Plastic Surgery, University Medical Center Groningen and University of Groningen.

Plastic and Reconstructive Surgery
|May 25, 2022
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Summary
This summary is machine-generated.

Objective software now quantifies smile reanimation success. Cross-facial nerve grafts show superior spontaneous smile emotionality compared to other methods, aiding future surgical outcome analysis.

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Area of Science:

  • Plastic Surgery
  • Machine Learning in Medicine
  • Facial Nerve Reconstruction

Background:

  • Restoring spontaneous, emotional smiles is a key goal in smile reanimation surgery.
  • Optimal surgical techniques for reliable spontaneity remain unclear.
  • Automated machine learning tools are being developed for objective analysis of spontaneous smiling.

Purpose of the Study:

  • To develop and test an objective tool using machine learning to analyze spontaneous smiling.
  • To evaluate the feasibility of this tool in patients undergoing functional free muscle transfers for smile reanimation.

Main Methods:

  • Utilized validated humorous videos to elicit spontaneous smiles.
  • Employed automated facial landmark recognition (Emotrics) and emotion detection software (Affdex) for analysis.
  • Quantified spontaneous smile expressiveness using the emotionality quotient in normal subjects and facial palsy patients.

Main Results:

  • The developed software successfully analyzed spontaneous smiling in all subjects.
  • Normal subjects' spontaneous smiles showed 100% joy and 0% negative emotion (EQ score +100/0).
  • Facial palsy patients demonstrated varying emotionality quotient scores based on reanimation technique: cross-facial nerve graft (+82/0), masseteric nerve (0/-48), and dual innervation (+10/-24).

Conclusions:

  • Computer vision software objectively quantifies spontaneous smiling outcomes in smile reanimation.
  • Gracilis functional free muscle transfer innervated by a cross-facial nerve graft yielded greater emotionality in spontaneous smiles compared to masseteric or dual innervation.
  • Objective quantification of spontaneous smiling can support future multicenter trials to establish definitive success rates for various reanimation procedures.