Dr. Panossian performs all styles of smile reanimation surgery including gracilis muscle transfer with and without cross face nerve graft and his signature technique, called the lengthening temporalis myoplasty.

Before and after of young girl after lengthening temporalis myoplasty.

Procedure
Unilateral sliding temporalis myoplasty
Lower lip myectomy

Details for Patient # 20854
6-year-old girl with facial paralysis following brain tumor excision, underwent smile reanimation using a sliding temporalis myoplasty. To establish symmetry of her smile in one surgery, she underwent simultaneous excision of her active lower lip depressor muscle (ie, lower lip myectomy) on the non-paralyzed side. Shown here at 3 months postop with excellent symmetry of smile and good control.

Before and after of young girl after lengthening temporalis myoplasty.

Procedure
Left sliding temporalis myoplasty
Contralateral lower lip depressor muscle resection for symmetry

Details for Patient # 22823
10-year-old female with unilateral facial paralysis secondary to medulloblastoma excision, underwent left temporalis myoplasty to reanimate her smile. The results were immediate with progressive improvement in strength and excursion of smile. She simultaneously underwent excision of the strong downward depressor muscles of the normal lower lip to balance out her smile. Shown here at 7 months postop with excellent symmetry.

Before and after of young boy after lengthening temporalis myoplasty.

Procedure
Unilateral sliding temporalis myoplasty
Lower lip myectomy

Details for Patient # 20996
8-year-old boy with unilateral facial paralysis following brain tumor excision, underwent single-stage sliding temporalis myoplasty for smile reanimation. He also underwent simultaneous lower lip myectomy (ie, muscle excision) of the non-paralyzed side for symmetry. Shown here nearly 2 years postop with excellent symmetry of smile.

Before and after of young boy with Moebius syndrome after bilateral gracilis muscle transplants.

Procedure
Smile reanimation with bilateral gracilis muscle transfers

Details for Patient # 20992
5-year-old boy with Mobius syndrome underwent sequential bilateral free gracilis muscle transfers to reanimate his smile. The muscle was connected to the masseter nerve for biting. Shown here 2 years postop with good symmetry.

Before and after of young boy after lengthening temporalis myoplasty.

Procedure
Left lengthening temporalis myoplasty

Details for Patient # 23009
7-year-old boy with left facial paralysis following brain tumor excision, underwent left lengthening temporalis myoplasty. Shown here at 8 months demonstrating excellent healing and modest smile movement.

Before and after of young girl after gracilis muscle transplant and cross face nerve graft.

Procedure
Cross-face nerve graft
Gracilis muscle transplant

Details for Patient # 44213
9-year-old girl born with right-side facial paralysis of unknown cause. She underwent 2-stage smile reanimation using a cross-face nerve graft followed by gracilis muscle transplant. She is shown here 7 years postop.

Before and after of boy with facial paralysis after masseter-to-facial nerve transfer.

Procedure
Masseter-to-facial nerve transfer

Details for Patient # 32445
17-year-old boy with partial facial nerve palsy of left face following soft tissue tumor excision, underwent masseter-to-facial nerve transfer for improvement in smile symmetry and eye closure. Shown here 12 months postop with continuing improvement in smile symmetry and nasolabial fold production.

Before and after of woman with facial paralysis after gracilis muscle transplant.

Procedure
Smile reanimation with gracilis muscle transfer

Details for Patient # 14317
45-year-old female with unrecovered Bell's palsy, underwent free gracilis muscle transfer to left face for smile reanimation. Shown here 1 year postop with excellent symmetry, smile vector, and range of motion.

Before and after of young woman with Moebius syndrome after gracilis muscle transplant.

Procedure
Gracilis muscle transplant to masseter nerve

Details for Patient # 27667
16-year-old girl with Moebius syndrome, underwent left-side gracilis muscle transplant to masseter nerve. Shown here 8 months postop demonstrating excellent control and symmetry of her smile.

Before and after of woman after repair of traumatic facial nerve injury.

Procedure
Early facial nerve repair

Details for Patient # 27313
52-year-old woman sustained a traumatic facial laceration. She underwent early facial nerve exploration and primary repair with excellent progress at 20 months postop.

Before and after of young girl after gracilis muscle transplant and cross face nerve graft.

Procedure
Gracilis muscle transplant
Cross-face nerve graft

Details for Patient # 22800
12-year-old girl with facial paralysis secondary to trauma, underwent right-sided smile reanimation using a cross-face nerve graft, followed 9 months later by a free gracilis muscle transplant. Shown here 2 years postop with good facial contour and smile movement.

Before and after of young boy with Moebius syndrome after bilateral lengthening temporalis myoplasties.

Procedure
Bilateral sliding temporalis myoplasty

Details for Patient # 23658
8-year-old boy with Mobius syndrome underwent smile reanimation using bilateral sliding temporalis myoplasty single-stage procedure. Shown here at 20 months postop, showing excellent smile movement and symmetry.

Before and after of young girl with Moebius syndrome after bilateral gracilis muscle transplants.

Procedure
Smile reanimation with bilateral gracilis muscle transfers

Details for Patient # 23809
5-year-old girl with Mobius syndrome underwent bilateral free gracilis muscle transfers to reanimate her smile. The muscles were connected to the masseter nerve for biting. Shown here 6 years postop with good symmetry and smile movement.

Before and after of young girl after gracilis muscle transplant and cross face nerve graft.

Procedure
Smile reanimation with cross-face nerve graft and gracilis muscle transfer
Lower eyelid suspension
Lower lip myectomy for symmetry

Details for Patient # 23188
5-year-old girl with right unilateral facial paralysis, underwent a two-stage smile reconstruction using cross-face nerve graft and free gracilis muscle transfer. She also underwent eyelid suspension for failure to close the right eye. Lower lip muscle excision on the non-paralyzed side was also performed for symmetry. Shown here 6 years postop with excellent symmetry and eyelid suspension.

Before and after of man with facial paralysis following lengthening temporalis myoplasty.

Procedure
Temporalis lengthening myoplasty

Details for Patient # 58678
7-year-old boy with complete left facial paralysis after being struck by a car, underwent a left temporalis lengthening myoplasty procedure. He is shown here 3 years postop with adequate mobility of his mouth and smile.

Before and after of young girl with facial paralysis after gracilis muscle transplant.

Procedure
Smile reconstruction using gracilis muscle transfer to masseter nerve

Details for Patient # 44837
6-year-old female with unilateral facial paralysis (mild variant of Mobius syndrome), underwent smile reconstruction using a free gracilis muscle transfer. The nerve of the gracilis was connected to the functioning masseter nerve (cranial nerve V) to trigger smile function. She shows excellent excursion of her smile with good symmetry.

BEFORE AND AFTER GALLERY

DR. PANOSSIAN APPEARS ON THE DOCTORS

DR. PANOSSIAN RECEIVES TOP AWARD FOR NEW TECHNIQUE

Best Paper Award for Andre Panossian, MD for top plastic surgery.

 

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