Rapid Restoration: Suture Stabilization of the Central Facial Landmarks.

BACKGROUND

Reinnervation procedures for patients with flaccid facial paralysis (FFP) often require a lengthy delay until facial symmetry is restored. We have incorporated a simultaneous suture-based "rapid restoration" (RR) to symmetrize the mid- and lower face in the early postoperative period.

METHODS

We studied patients with FFP who underwent facial reanimation from March 2022 to February 2025 where dynamic changes were not expected for at least 4 months. We used Emotrics to measure nasolabial fold (NLF) angle, upper lip slope, and oral commissure (OC) height and calculated symmetry indices.

RESULTS

We included 13 patients who underwent RR and 15 patients who underwent only dynamic reanimation. Patients who underwent RR experienced the following median changes: resting NLF angle increase from 7.1° to 26.0° with improvement in symmetry index from 22.7% to 88.9% (p < 0.001); upper lip slope decrease from 26.2° to 21.2° with improvement in symmetry index from 42.7% to 76.0% (p = 0.025); and OC height asymmetry decrease from 5.7 to 1.8 mm (p < 0.001). Patients who did not undergo simultaneous RR realized no significant changes in NLF angle, upper lip slope, or OC height.

CONCLUSIONS

RR performed alongside dynamic facial reanimation procedures helps to eliminate major asymmetry associated with FFP while awaiting restoration of facial function.