"A smile is a universal greeting and it's often the starting point for all social interactions. Unfortunately, some people cannot smile or are too self-conscious because of a defect, droopiness or wrinkles around the mouth, or protruding gums. The inability to smile can be devastating to a person's self-image," said Richard D'Amico, MD, ASPS president.
Facial reanimation treats two types of people - those who are born without the ability to smile on one or both sides of their face and those who, due to traumatic accident, tumour or illness, like Bell's palsy, can no longer smile.
Dr. Jeffrey Marcus and his partner, Michael Zenn, MD, developed the multi-disciplinary program at Duke University.
Facial reanimation consists of one or two microsurgical procedures that involve connecting a specific nerve in the face to a transferred functional muscle taken from the leg.
The nerve serves as an energy source while the muscle acts like a motor to create the motion needed to smile. For a patient who can't smile on one side, a nerve graft (taken from the back of the calf) is connected to the nerve on the functional side of the face and extended to the paralysed side.
The nerve graft acts like an extension cord providing electrical currents to the paralysed side. Six to twelve months later, after the nerve on the paralysed side becomes "live", the muscle is connected and its artery and vein are attached to vessels in the face.
Typically, for a patient who can't smile on both sides, the muscle is transferred and attached, in one procedure, to a nerve found on both sides of the face not usually used to smile, but is responsible for chewing.
In addition to reconstructing a smile, rejuvenating the aging or unattractive smile is a facial area that has not been commonly discussed.
Andrew Wexler MD, said: "Restoring a smile's motion is only the start of making a beautiful smile. The beautiful smile is a complex combination of lip and dental anatomy, which creates an aesthetic balance we view as beautiful.
As with all plastic surgery, there are visual norms and factors, like symmetry, shape and texture that make up what is instinctively known as beautiful. Plastic surgeons have surgical and non-surgical procedures and devices available to address areas of concern around the mouth.
The procedures will be presented at the American Society of Plastic Surgeons (ASPS) and American Society of Maxillofacial Surgeons (ASMS) Plastic Surgery 2008 conference, Oct. 31 - Nov. 5, in Chicago.