Incorporating local muscle and tendon for facial reanimation

Local muscle and tendon can be readily incorporated for facial reanimation procedures specifically related to the midface and periorbital area. Our objective is to describe temporalis muscle and tendon procedures that increase smile excursion including indications, modifications of these procedures, perioperative care, and reported outcomes. Temporalis tendon and muscle procedures capitalize on the redundancy of the muscles of mastication to repurpose for facial reanimation. Temporalis tendon transfer is indicated for patients who benefit from immediate results with a low risk, low morbidity procedure that can improve lip symmetry at rest and with smiling. The technique has evolved to be more minimally invasive with 1 or 2 incisions in an outpatient surgery that provides the same or more benefit from the originally described technique. Provider and patient reported questionnaires as well as computer-based algorithms have been reported to assess subjective and objective outcomes for this procedure.