Facial Muscle Reanimation Procedures

Facial muscle reanimation treatment options depend on the exact cause and duration of paralysis. The goals of treatment are to restore the smile, reduce vision impediments, and reduce disfigurement related to brow and cheek droop. There are two strategies used to restore and rehabilitate patients with facial paralysis – dynamic and static reanimation techniques. Dynamic techniques attempt to restore movement of the native facial muscles. Static reanimation techniques, however, attempt to restore form and appearance without restoring actual movement. It is important to seek consultation with a specialist who is trained in the broad range of reconstructive options to better serve your needs. To learn more about Facial Paralysis, the condition, please visit our other supporting page.
Facial Muscle Reanimation Testing by Dr. Mourad

Preparation For Facial Muscle Reanimation

You will meet with Dr. Mourad where he usually spends an hour going over everything related to your surgery. He will evaluate and make sure that he can specifically tailor a custom care plan to your exact needs. During the consultation, Dr. Mourad will determine the exact nature of your complaints and the exact causes. He may prescribe medications that will assist in your complaints. Once a tailored plan is made, Dr. Mourad and his staff will take you through all the necessary information needed to make sure that your surgery happens without issue. We take care of the details so that you can have the most enjoyable experience.

Dr. Mourad views treating his patients to be nothing short of a privilege and an honor and enjoys taking the time to get to know his patients and fully understand their issues. Dr. Mourad’s office provides a boutique experience that takes you out of the mindset of being at the doctor’s office. It is a warm, comfortable environment, providing a bespoke experience.

Facial Muscle Reanimation: Dynamic Techniques

Cable Nerve Grafting

Facial paralysis that results from transection of the nerve, for example from trauma, or surgery, may be treated with cable grafting. This technique involves replacing a segment of damaged nerve with healthy nerves from the patient. Nerves can be obtained from the legs or neck and used as grafts to connect the damaged and/or severed nerve endings.

Cross Nerve Grafting

Long segments of healthy donor nerves are used to connect the facial nerve from the unaffected side to the paralyzed side.

Jump Nerve Grafting

Jump grafting uses neighboring nerves that control the tongue or jaw to connect to the damaged facial nerve. By controlling the jaw and/or tongue, a person can learn to control their facial muscles.

Temporalis Muscle Transfer

This technique involves the attachment of muscles that move the jaw to the facial muscles. By activating the jaw muscle, a patient may learn to voluntarily control their smile.

Gracilis Free Flap

Muscle, nerves, and arteries are obtained from the inner thigh and used to reconstruct a patient smiling through attachment to the muscles of the face.

Facial Muscle Reanimation: Static Techniques

Tissue Slings

A tissue sling may be used to suspend and elevate the paralyzed side of the face into a more favorable position. Tendon like tissue can be harvested from the thigh in order to serve as the sling. Other slings may involve the use of synthetic material or tendons harvested from other body sites.

Lid Tightening Procedures

Also known as a tarsorrhaphy, the lower eyelids can be placed in a more favorable position by tightening and repositioning the eyelid in a more favorable position.

Gold Weights

Small gold weights can be placed in a pocket in the upper eyelid in order to allow gravity to assist in closing the eyes.

Brow Lift

Facial Paralysis may cause the brow and forehead to droop. This descent can be so severe that it may compromise vision. Brow lifts involve elevating the brow and placing in a more favorable and natural position.


Some patients may experience nasal congestion and airway obstruction due to a collapse of the nasal structures on the affected side. Reconstruction of the nose to reinforce the collapse will allow for improved breathing.

After Surgery and Recovery

Depending on your work, Dr. Mourad typically recommends taking a minimum of 3 days off before returning to work. He also discourages his patients from any heavy lifting. If you wear glasses, you may require some alterations if applicable. Dr. Mourad will provide you with pain medications, ointments, nasal sprays, all to help maximize your results. Dr. Mourad will then see you in visitations two weeks later, and then one month after that. Dr. Mourad enjoys the continued visitation of his patients and will see them in follow up for many years thereafter.

Associated Risks

  • Anesthesia: Depending on the type of anesthesia administered, patients may have a reaction. This is exceedingly rare, and it is important to discuss your personal risk with your anesthesiologist.
  • Infection: In rare circumstances patients may develop an infection following reconstructive procedures. These are usually managed with intraoperative and postoperative antibiotics.
  • Bleeding: Although rare, patients may have bleeding episodes following reconstructive surgery. Your surgeon will likely order blood work to make sure you are healthy enough to undergo the procedure, and minimize risk of bleeding. Your surgeon should also go over all medications and supplements to minimizing bleeding risk.
  • Need for secondary surgeries: Depending on the complexity of the reconstruction, sometimes multiple surgeries are required to ensure the best aesthetic and functional outcomes.
  • Scarring and Poor wound healing: Some patients with underlying medical conditions or more prone to poor wound healing and scarring. It is important to understand these risks prior to embarking on a treatment strategy.

Meet Dr. Moustafa Mourad, MD, FACS

Moustafa Mourad, MD, FACS is board-certified in head and neck surgery and highly-trained in cosmetic plastic surgery and facial reconstruction. Dr. Mourad is also a Fellow of the American College of Surgeons. He treats many conditions, both cosmetic and complex, that affect the head, neck and entire facial area. Learn More »

Select Relevant Publications

Mourad M, Arnaoutakis D, Sawahney R, Ducic Y. Use of the Giant Bilobed Flap in Head and Neck Reconstruction. Facial Plastics Surgery. 2016 Jun;32(3):320-324. Link to Article.

Kadakia S, Mourad MW, and Ducic Y. Supraclavicular Flap Reconstruction of Cutaneous Defects Has Lower Complication Rate than Mucosal Defects. Journal of Reconstructive Microsurgery. 2017 May; 33(4):275-280. Link to Article.

Moubayed S, Mourad MW, Lee T, and Ducic Y. An Overview of Regional Tissue Transfer for Head and Neck Reconstruction. Head and Neck Cancer. 2016 Feb. Link to Article.

Mourad MW, Moubayed S, Inman J, and Ducic Y. Microvascular Reconstruction of the Head and Neck. Head and Neck Cancer. 2016 Feb. Link to Article.

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