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Updated: Aug 9, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Strategies for nasolabial levitation
1Division of Plastic Surgery, University of California, Irvine, USA.
Abstract:
A facelift strategy that has proved useful follows certain steps: (1) incision lines and excision lines are drawn preoperatively with the patient seated, providing a pattern for skin excision. (2) The skin/soft-tissue flap is elevated from the surface of the SMAS, platysma, and frontalis (SMA plane). (3) The retaining ligaments of the cheek are released. (4) The zygomaticus major muscle is plicated. (5) Advancement of the zygomatic ligament is emulated by sutures from the modiolar retinacular tissue to the zygomatic periosteum/masseteric aponeurosis. (6) Closure of the patterned skin excision takes up the intrinsic nasolabial redundancy and also the nasolabial redundancy resulting from steps 4 and 5.
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