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Implantable and Prosthetic Devices for Dynamic Facial Reanimation: A Scoping Review
Matthew L Harris1, Mitesh P Mehta2, Zain G Siddiqi1
1Emory University School of Medicine, Atlanta, Georgia, USA.
Facial Plastic Surgery & Aesthetic Medicine
|November 18, 2025
Summary
Implantable and prosthetic devices show promise for dynamic facial reanimation, with electromyography-functional electrical stimulation (EMG-FES) systems being the most viable near-term option. These technologies could offer new solutions for patients with limited surgical choices.
Area of Science:
- Biomedical Engineering
- Reconstructive Surgery
- Neuroprosthetics
Background:
- Facial paralysis presents significant challenges for patients, impacting communication and quality of life.
- Current surgical techniques for facial reanimation have limitations.
- There is a growing need for advanced, dynamic solutions for facial movement restoration.
Purpose of the Study:
- To review and assess implantable and prosthetic devices for dynamic facial reanimation.
- To evaluate the mechanisms, effectiveness, and clinical feasibility of these emerging technologies.
- To identify the most promising approaches for future development.
Main Methods:
- Scoping review of 34 primary studies published since 2000.
- Categorization of devices into four main types: EMG-FES, artificial muscles, electromagnetic actuators, and wearable prosthetics.
- Analysis of research focus, including periocular, midface, and smile restoration.
Main Results:
- Electromyography-functional electrical stimulation (EMG-FES) systems demonstrated robustness in animal models and represent the most researched category.
- Artificial muscles, electromagnetic actuators, and wearable prosthetics are largely in theoretical or early developmental stages.
- Most studies focused on restoring periocular function (blinking), with some addressing midface and smile reanimation.
Conclusions:
- Implantable and prosthetic devices hold potential to supplement or replace current facial reanimation surgeries.
- EMG-FES systems present the most viable near-term therapeutic option.
- Further research and long-term safety studies are crucial for clinical translation and patient benefit, particularly for those with limited surgical alternatives.
