Orthodromic transfer of the temporalis tendon with extension of the fascia lata to reanimate the smile in facial palsy

Facial nerve palsy is a debilitating condition. The gold standard for facial reanimation is free tissue transfer with cross-facial grafts,1,2 but the outcome is unpredictable and the procedure depends upon the precision with which the technique is used. Orthodromic transfer of the temporalis muscle with or without an extension graft can re-establish the harmony of facial muscles during rest and animation.3,4 Unlike other techniques, it is predictable and offers early animation of the oral commissure and lower face.

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