Management of Long-Standing Flaccid Facial Palsy: Static Approaches to the Brow, Midface, and Lower Lip

Abstract

Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. A horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. While dynamic reanimation is the gold standard for rehabilitation, there are cases in which static approaches are more appropriate or may be used as an adjunct to dynamic techniques. This article focuses on the surgical management of FFP primarily using static approaches to the individual zones of the face to create resting symmetry.

Keywords: Brow ptosis; Chemodenervation; External nasal valve collapse; Facial nerve paralysis; Flaccid facial paralysis; Myectomy; Selective neurectomy; Static suspension.