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International and Multispecialty Expert Consensus on Standardization of Facial Reanimation Surgical Outcomes
Matthew Q Miller1, Babak Azizzadeh2, Rachel Baptista3
1Department of Facial Plastic & Reconstructive Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
Background:
The timing of outcome assessments and tools used to track results after facial reanimation procedures varies considerably throughout the literature. Comparative evaluation of results is not possible without standardized reporting guidelines.
Objective:
To develop standardized outcome reporting guidelines for commonly performed facial reanimation procedures using expert consensus.
Methods:
Twenty-two international facial nerve experts participated in online surveys between January 2025 and August 2025 to review and report current practices in facial reanimation outcomes research. This group met in person in September 2025 to develop outcome standardization statements. A final online survey established consensus, defined by agreement of at least 80% of the group.
Results:
Experts represented 12 countries and 5 continents. They developed guidelines for general outcomes reporting (6), facial nerve repair (6), free muscle transfer smile reanimation (9), selective facial myectomies (8), nerve transfers (7), selective facial neurectomies (6), and static facial suspension and temporalis transfer (5). Of these statements, all but one reached consensus. The entire group agreed on 35 (74%) statements.
Conclusions:
A multispecialty international group of facial reanimation experts developed 46 consensus recommendations for reporting outcomes after facial reanimation procedures. These guidelines should facilitate unbiased evaluation of surgical results and comparative effectiveness research.
