Reclaim Your Smile with Dr. Panossian in Pasadena

Are you tired of feeling self-conscious about your smile due to facial paralysis? Dr. Panossian understands the grief facial paralysis can cause, robbing individuals of their ability to express joy and often leaving them feeling insecure. Smile reanimation offers a glimmer of hope, promising to restore not just smiles but confidence as well. As a leading expert in facial reanimation and smile restoration, Dr. Panossian has dedicated his career to helping individuals like you rediscover the joy of smiling. With accolades such as the "Best Reconstructive Paper" award from the American Society of Plastic Surgeons for his work in developing this procedure, Dr. Panossian is the trusted choice for smile reanimation.

What Is Smile Reanimation (TEMPORALIS MYOPLASTY)?

Smile reanimation, specifically through temporalis myoplasty, is a groundbreaking procedure designed to address facial paralysis by restoring facial symmetry and function. The temporalis muscle, originating from the side of the skull and extending to the lower jaw, plays a crucial role in biting and chewing. By leveraging its natural function, this procedure involves the transfer of the temporalis muscle to the corner of the mouth and upper lip, enabling the recreation of a dynamic smile. Smile reanimation and facial reanimation procedures serve distinct purposes in addressing facial paralysis. While smile reanimation, particularly through techniques like temporalis transfers, is typically employed for chronic conditions associated with long-standing facial paralysis, facial reanimation procedures often focus on acute conditions or immediate post-injury interventions. Understanding this distinction is crucial in determining the most suitable treatment approach for each patient's needs.

Unlike the "temporalis tendon transfer," a more abbreviated version, temporalis myoplasty offers distinct advantages. Dr. Panossian has dedicated nearly a decade to refining this technique to produce natural and predictable results. While the concept of using the temporalis muscle for smile reanimation isn't new—dating back to Dr. C.R. McLaughlin's temporalis tendon transfer in 1953—it wasn't until Dr. Daniel Labbé developed the lengthening temporalis myoplasty that significant advancements were made. Dr. Labbé's work laid the foundation for Dr. Panossian's modifications, which have greatly improved recovery time, predictability, and scarring. This technique represents a significant leap forward in smile reanimation by eliminating the need for an intervening tendon or fascia lata graft. Dr. Panossian's expertise, combined with his innovative contributions recognized by the "Best Reconstructive Paper" award from the American Society of Plastic Surgeons in 2016, positions him as a trusted leader in smile reanimation.

Plastic Surgeon Explains Lengthening Temporalis Myoplasty for Smile Reanimation

human face diagram of muscle

Additional Smile Reanimation Treatment Options

In addition to temporalis myoplasty, several other treatment options are available for smile reanimation, each tailored to address specific cases of facial paralysis. While each treatment option has its benefits and considerations, the choice depends on factors such as the underlying cause of facial paralysis, the extent of nerve damage, and the patient's individual needs and goals. Consulting with Dr. Panossian is essential to determine the most suitable treatment plan for achieving optimal smile reanimation results.

  • Gracilis Muscle Transplant (Cross Face Nerve Graft): This technique involves transplanting the gracilis muscle from the thigh to the face and connecting it to the opposite healthy facial nerve using a nerve graft. It allows for restoring facial movement by utilizing the healthy nerve supply from the unaffected side of the face.
  • Gracilis Muscle Transplant (Masseter Nerve): Similar to the cross-face nerve graft, this procedure utilizes the gracilis muscle from the thigh. However, instead of connecting it to the opposite healthy facial nerve, it is linked to the masseter nerve on the affected side of the face. This approach aims to achieve smile reanimation by utilizing a nearby nerve source.
  • Cross-Face Nerve Graft: In cases where the facial nerve on one side of the face is damaged or non-functional, a cross-face nerve graft involves harvesting a nerve from the healthy side of the face and grafting it onto the paralyzed side. This approach allows for the restoration of nerve function and enables facial movement.
  • Nerve Transfers: Nerve transfers redirect a healthy nerve from a less critical muscle to the paralyzed facial muscles, restoring function. This approach can offer significant improvements in smile symmetry and movement.
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The Benefits of Smile Reanimation (Temporalis Myoplasty)

Dr. Panossian understands the emotional toll facial paralysis can take, especially regarding your desire for a natural smile. With smile reanimation (temporalis myoplasty), Dr. Panossian offers a transformative procedure designed to bring back the joy of smiling. Here are some of the key benefits:

  • Natural Smile Restoration: Temporalis Myoplasty restores facial movement in a way that closely mimics natural smiling, allowing for authentic expressions of joy and emotion.
  • Improved Symmetry: This procedure can enhance facial symmetry by reanimating the facial muscles, creating a more balanced and aesthetically pleasing appearance.
  • Enhanced Facial Expressions: Smile Reanimation enables a wider range of facial expressions, including smiles, grins, and other subtle movements, helping you communicate effectively and express yourself confidently.
  • Increased Confidence: After restoring facial movement, patients often experience a boost in self-esteem and confidence, feeling more comfortable and at ease in social interactions.
  • Long-lasting Results: Dr. Panossian's expertise ensures that Smile Reanimation delivers durable and long-lasting results, improving facial function and appearance.
  • Personalized Approach: Each Smile Reanimation procedure is tailored to the patient's unique needs and goals, ensuring optimal outcomes and satisfaction.

Is Smile Reanimation Right for Me?

Smile reanimation (temporalis myoplasty) is ideal for individuals experiencing facial paralysis or weakness resulting from conditions such as Bell's palsy, stroke, or facial nerve damage. Common symptoms indicating a potential benefit from this procedure include difficulty smiling, asymmetry of the face, and limited facial movement. If you cannot express emotions fully due to facial paralysis or feel self-conscious about your smile, smile reanimation may be the solution you've been seeking. However, every case is unique, and a consultation with Dr. Panossian is essential to determine if this procedure fits your specific needs. During your consultation, Dr. Panossian will thoroughly evaluate your condition, discuss your goals and expectations, and develop a personalized treatment plan tailored to achieve the best possible outcomes for you.

Smile Reanimation Before & After

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What to Expect: The Temporalis Myoplasty Procedure

During a temporalis muscle transfer procedure, incisions are strategically planned along the hairline from the mid-forehead towards the sideburn, extending along the path of a standard facelift to the earlobe. Another incision is made at the lip-cheek junction (nasolabial fold) to anchor the temporalis tendon. Once the patient is under anesthesia, the temporalis muscle is initially mobilized, completely released within its natural position in the temporalis fossa, suspended only by its nerve and blood supply. The zygomatic bone is temporarily detached to access the muscle tendon, and the portion of the mandibular bone to which the tendon is attached is disconnected, keeping the tendon intact. A tunnel is created to deliver the tendon and attached coronoid process through the nasolabial incision.

After separating the bone from the tendon, it is precisely inserted along the corner of the mouth and upper lip. The muscle is then rotated by 90 degrees to provide additional length to the tendon, termed "lengthening" myoplasty. This adjustment allows the muscle to reconfigure along its new position, providing maximum excursion without requiring additional grafts. Once the muscle and tendon are secured in their new positions, the muscle is stimulated to assess movement adequacy and make necessary adjustments for the best smile. Typically performed under general anesthesia, the procedure lasts approximately 3.5 to 4.5 hours and may be combined with other facial surgeries for symmetry. Drains and a thin pain pump catheter are often placed to manage postoperative fluid drainage and muscle spasms, improving comfort during recovery.

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Temporalis Myoplasty Recovery

After undergoing temporalis myoplasty, patients can expect a period of recovery and healing. Initially, a bulky soft dressing and facial support garment are applied, with drains and tubes typically removed within the first two to three days postoperatively. We advise patients to follow a soft diet immediately after surgery, consisting of foods such as soups, yogurt, and well-cooked chicken, while avoiding hard foods like fruits and vegetables for approximately four weeks. Swelling of the face and eyelids may occur but typically resolves within the first week, accompanied by bruising that diminishes over the same period. During the initial 4 to 6 weeks post-surgery, patients are encouraged to engage in light walking and stationary activities, avoiding heavy lifting, contact sports, and aerobic exercises. Many adults opt to take 7 to 14 days off from work during this time, with makeup available to mask any remaining bruising. While some cases may permit outpatient procedures, others may require overnight stays for comfort or assistance. Physical therapy starts around three weeks post-surgery to promote temporalis muscle mobility, often involving visits to a facial paralysis therapist for exercises, biofeedback, and scar management to ensure optimal healing and muscle function over the following months.

Temporalis Myoplasty Recovery

After undergoing temporalis myoplasty, patients can expect a period of recovery and healing. Initially, a bulky soft dressing and facial support garment are applied, with drains and tubes typically removed within the first two to three days postoperatively. We advise patients to follow a soft diet immediately after surgery, consisting of foods such as soups, yogurt, and well-cooked chicken, while avoiding hard foods like fruits and vegetables for approximately four weeks. Swelling of the face and eyelids may occur but typically resolves within the first week, accompanied by bruising that diminishes over the same period. During the initial 4 to 6 weeks post-surgery, patients are encouraged to engage in light walking and stationary activities, avoiding heavy lifting, contact sports, and aerobic exercises. Many adults opt to take 7 to 14 days off from work during this time, with makeup available to mask any remaining bruising. While some cases may permit outpatient procedures, others may require overnight stays for comfort or assistance. Physical therapy starts around three weeks post-surgery to promote temporalis muscle mobility, often involving visits to a facial paralysis therapist for exercises, biofeedback, and scar management to ensure optimal healing and muscle function over the following months.

Smile Reanimation Risks & Potential Complications

Smile reanimation, particularly through temporalis transfers, is generally associated with low risks and potential complications, especially when performed by a skilled and experienced facial paralysis surgeon like Dr. Panossian. However, as with any surgical procedure, there are inherent risks. These include standard surgical risks such as bleeding (hematoma), infection, or adverse reactions to anesthesia. Additionally, factors such as uncontrolled diabetes and smoking may impact healing and overall results in adult patients. Given the dynamic nature of the procedure, there is a slight risk of minor asymmetry and excessive scarring beneath the skin, which could potentially limit lip movement. Sometimes, a revision may be necessary to address such concerns, typically as an outpatient procedure lasting 1-2 hours. It is essential to closely follow Dr. Panossian's pre- and postoperative instructions to mitigate these risks. Our dedicated staff is always available to provide guidance and clarification regarding these instructions, ensuring the best possible outcomes for each patient.

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Why Choose Dr. Panossian?

Choosing Dr. Panossian for smile reanimation is choosing expertise, compassion, and innovation. With years of dedicated experience in facial reanimation, Dr. Panossian stands at the forefront of pioneering techniques like temporalis myoplasty. If you're grappling with insecurities stemming from facial paralysis, know that Dr. Panossian empathizes with your journey and offers a beacon of hope through smile restoration. His groundbreaking contributions, exemplified by the "Best Reconstructive Paper" award from the American Society of Plastic Surgeons in 2016 for this exact procedure, underscore his commitment to advancing the field and achieving exceptional outcomes for his patients. Don't let facial paralysis hold you back from experiencing the joy of smiling. Take the first step towards reclaiming your confidence and happiness–schedule a consultation with Dr. Panossian today.

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