Davos Courses

General Editor: Daniel Buchbinder

Authors: Damir Matic, John Yoo

Facial nerve - Irreversible paralysis, midface and mouth - Innervated free muscle transfer (Gracilis)

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Modified facelift or parotidectomy incision


The most common approach used to expose the facial nerve and treatment options for reconstruction of the paralyzed face is the modified facelift or parotidectomy incision.

The main anatomic structures|alt enlarge

Skin incision

A modified facelift incision is made through skin and subcutaneous tissues. This incision may vary depending on local anatomy and hair distribution patterns.

Nerve localization and exposure

Proximal and distal branches of the facial nerve are exposed and identified based on specific anatomy and site of reconstruction, as described in the respective treatment section.

Wound closure

The wound is reapproximated in layers for anatomic realignment and closure of dead space.