Smile surgery

Smile surgery
Before and after dynamic smile reconstruction in facial paralysis
SpecialtyFacial Plastic and Reconstructive Surgery

Smile surgery or smile reconstruction is a surgical procedure that restores the smile for people with facial nerve paralysis. Facial nerve paralysis is a relatively common condition with a yearly incidence of 0.25% leading to function loss of the mimic muscles.[1] The facial nerve gives off several branches in the face. If one or more facial nerve branches are paralysed, the corresponding mimetic muscles lose their ability to contract.[2] This may lead to several symptoms such as incomplete eye closure with or without exposure keratitis, oral incompetence, poor articulation, dental caries, drooling, and a low self-esteem.[3][4] This is because the different branches innervate the frontalis muscle, orbicularis oculi and oris muscles, lip elevators and depressors, and the platysma. The elevators of the upper lip and corner of the mouth are innervated by the zygomatic and buccal branches.[5] When these branches are paralysed, there is an inability to create a symmetric smile.[3]

Smile surgery is performed as a static or dynamic reconstruction. An example of static reconstruction is upper and lower lip shortening or thickening with commissure preservation.[6] Dynamic smile reconstruction procedures restore the facial nerve activity.

  1. ^ Werker, P.M.N (2007). "Plastische chirurgie bij patienten met een aangezichtsverlamming". Nederlands Tijdschrift voor Geneeskunde. 151: 287–294.
  2. ^ Terzis JK, Konofaos P (May 2008). "Nerve transfers in facial palsy". Facial Plast Surg. 24 (2): 177–93. doi:10.1055/s-2008-1075833. PMID 18470829.
  3. ^ a b Bianchi B, Copelli C, Ferrari S, Ferri A, Sesenna E (November 2010). "Facial animation in patients with Moebius and Moebius-like syndromes". Int J Oral Maxillofac Surg. 39 (11): 1066–73. doi:10.1016/j.ijom.2010.06.020. PMID 20655175.
  4. ^ Lindsay RW, Hadlock TA, Cheney ML (July 2009). "Bilateral simultaneous free gracilis muscle transfer: a realistic option in management of bilateral facial paralysis". Otolaryngol Head Neck Surg. 141 (1): 139–41. doi:10.1016/j.otohns.2009.03.005. PMID 19559974. S2CID 21895398.
  5. ^ Faria JC, Scopel GP, Ferreira MC (January 2010). "Facial reanimation with masseteric nerve: babysitter or permanent procedure? Preliminary results". Ann Plast Surg. 64 (1): 31–4. doi:10.1097/SAP.0b013e3181999ea9. PMID 19801918. S2CID 46129054.
  6. ^ Static Reconstruction for Facial Nerve Paralysis at eMedicine