Facial reanimation: Evolving from static procedures to free tissue transfer in head and neck surgery

Brianna N. Harris, Travis Tate Tollefson

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


The purpose of this article is to review and evaluate the surgical options for treating patients with facial paralysis, covering primary neurorrhaphy to facial reanimation, with microvascular free tissue transfer. Recent findings In recent years, free tissue transfer has been increasingly common for rehabilitating the paralyzed face, providing a more dynamic and aesthetic outcome, than has been possible prior to microvascular surgery in facial plastic and head and neck surgery. Summary Although primary facial nerve repair attains the best results, nerve grafting with the sural nerve and commercially available motor nerve allografts can be used alone, or in combination with masseteric nerve grafts to attain facial tone and protect eyelid function. The workhorse for reanimation is the gracilis free tissue transfer innervated by the masseteric nerve or contralateral facial nerve using a cross-face nerve graft. The orthodromic temporalis tendon transfer has minimal donor site morbidity and acceptable reported outcomes. Static procedures continue to be used alone and in combination with other paradigms for facial nerve reanimation.

Original languageEnglish (US)
Pages (from-to)399-406
Number of pages8
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Issue number5
StatePublished - Jan 1 2015


  • Cable nerve graft
  • facial paralysis
  • gracilis free flap
  • masseter nerve
  • orthodromic temporalis tendon transfer
  • reanimation

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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