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Facial Reanimation Surgery

Facial reanimation is the process of surgically correcting facial paralysis; congenital or acquired through trauma or disease.

Type of procedures

There are various types of procedures that our physicians will use when planning your facial reanimation surgery. These may include:

  • Muscle transfers – This involves moving tendons and muscles from one part of your body, usually your legs or abdomen to your face. Some of the tendons that are moved include the temporalis tendon transfer, digastric tendon transfer and the gracillis. 
  • Nerve grafting – These procedures include moving nerves from different parts of the body to the face. By doing this, your physicians can be assured that you will have more movement and sensation in your face, allowing you to better control the muscles. This may include hypoglossal to facial grafting and cross facial grafting.

Frequently Asked Questions About Facial Reanimation Surgery

Facial plastic and reconstruction surgeon Patrick Byrne answers questions about facial paralysis surgical techniques. He provides information on the temporalis tendon transfer (T3) and gracilis free flap procedures.

Different Surgeries, Same Result

Two facial paralysis patients, were presented with the same surgical options to regain movement in their face --a temporalis tendon transfer or a gracilis free flap procedure Each option is safe and routinely performed at Johns Hopkins, but there is a lot to consider when making this important decision.

Facial Paralysis Patient Smiles Again

Left with facial paralysis following surgery to remove a brain tumor, Anthony struggled to blink, drink or smile. Follow Anthony’s journey as he has a temporalis tendon transfer and eye surgery performed by facial plastic and reconstructive surgeon Kofi Boahene to improve his quality of life.

Facial Reanimation Before and After Photos

Dr. Boahene facial paralysis two stage crossfacial nerve graft and gracilis flap
Result of smile restoring surgery for complete left sided facial paralysis. Procedures performed : Dual innervation with a combination of cross facial nerve graft and hypoglossal nerve transfer. The cross facial nerve graft recruits facial nerve function from the normal right face to allow a spontaneous smile and movement on the left side. The hypoglossal nerve restores tone to the left face and keep the lips symmetric when she talks. Procedure performed Kofi Boahene, M.D.
Dr. Boahene facial paralysis two stage crossfacial nerve graft and gracilis flap
Result after two stage cross facial nerve graft and Gracilis flap for smile restoration to correct right sided facial paralysis resulting from resection of acoustic neuroma. To produce an engaging smile the procedure is tailored to lift the upper lip to show teeth, define the smile lines to match the unaffected side, raise the Malay fat pads to reflect light and raise the corners of the mouth evenly. Right eyelid procedures were also performed to match the size of the unaffected side. Procedure performed by Dr. Boahene. The first and second procedures were performed 6 months apart.
Dr. Patrick Byrne Patient - Diagnosis: Right facial paralysis. Treatment: Temporal Tendon Transfer (T3), endoscopic browlift, lower/upper eye lid surgery, and a platinum chain weight.
Dr. Patrick Byrne Patient - Diagnosis: Right facial paralysis. Treatment: Temporal Tendon Transfer (T3), endoscopic browlift, lower/upper eye lid surgery, and a platinum chain weight.
Dr. Patrick Byrne Patient -Diagnosis: Right facial paralysis. Treatment: Temporal Tendon Transfer (T3); browlift; lower eye lid surgery; reconstruction of right lower lid with a medical and lateral eyelid lift surgery.
Dr. Patrick Byrne Patient -Diagnosis: Right facial paralysis. Treatment: Temporal Tendon Transfer (T3); browlift; lower eye lid surgery; reconstruction of right lower lid with a medical and lateral eyelid lift surgery.
Dr. Patrick Byrne Patient-Diagnosis: Bells Palsy, facial asymmetry and nasal obstruction. Treatment: Injections to open eyes more; face and necklift; lower eyelid surgery; septoplasty to repair valve collapse.
Dr. Patrick Byrne Patient-Diagnosis: Bells Palsy, facial asymmetry and nasal obstruction. Treatment: Injections to open eyes more; face and necklift; lower eyelid surgery; septoplasty to repair valve collapse.
Dr. Patrick Byrne Patient-Diagnosis: right facial paralysis. Treatment: revised tarsorraphy to allow eyes to open more; lower eye lid tightened; Temporal Tendon Transfer (T3), endoscopic browlift; chin implant.
Dr. Patrick Byrne Patient-Diagnosis: right facial paralysis. Treatment: revised tarsorraphy to allow eyes to open more; lower eye lid tightened; Temporal Tendon Transfer (T3), endoscopic browlift; chin implant.
Dr. Patrick Byrne Patient - Diagnosis: left facial paralysis. Treatment: Temporal Tendon Transfer (T3) surgery, browlift and transorbital canthopexy (tightening lower eyelid surgery).
Dr. Patrick Byrne Patient - Diagnosis: left facial paralysis. Treatment: Temporal Tendon Transfer (T3) surgery, browlift and transorbital canthopexy (tightening lower eyelid surgery).
Dr. Patrick Byrne Patient - Diagnosis: left facial paralysis. Treatment: Temporal Tendon Transfer (T3) surgery, left browlift, left facelift and placement of gold weight implant.
Dr. Patrick Byrne Patient - Diagnosis: left facial paralysis. Treatment: Temporal Tendon Transfer (T3) surgery, left browlift, left facelift and placement of gold weight implant.
Dr. Patrick Byrne Patient-Diagnosis: right facial paralysis due to temporal bone fracture. Treatment: targeted injections to improve asymmetry; Temporal Tendon Transfer (T3) and tightening lower right eyelid surgery.
Dr. Patrick Byrne Patient-Diagnosis: right facial paralysis due to temporal bone fracture. Treatment: targeted injections to improve asymmetry; Temporal Tendon Transfer (T3) and tightening lower right eyelid surgery.
Dr. Patrick Byrne Patient - Diagnosis: facial paralysis after a parotidectomy; Treatment: Temporal Tendon Transfer (T3) surgery, which doesn't cause any noticeable swelling or deformity of the face.
Dr. Patrick Byrne Patient - Diagnosis: facial paralysis after a parotidectomy; Treatment: Temporal Tendon Transfer (T3) surgery, which doesn't cause any noticeable swelling or deformity of the face.