Background: Reinnervation procedures for patients with flaccid facial paralysis (FFP) often require a lengthy delay until facial symmetry is restored. We have incorporated a simultaneous suture-based "rapid restoration" (RR) to symmetrize the mid- and lower face in the early postoperative period. Methods: We studied patients with FFP who underwent facial reanimation from March 2022 to February 2025 where dynamic changes were not expected for at least 4 months. We used Emotrics to measure nasolabial fold (NLF) angle, upper lip slope, and oral commissure (OC) height and calculated symmetry indices. Results: We included 13 patients who underwent RR and 15 patients who underwent only dynamic reanimation. Patients who underwent RR experienced the following median changes: resting NLF angle increase from 7.1 degrees to 26.0 degrees with improvement in symmetry index from 22.7% to 88.9% (p < 0.001); upper lip slope decrease from 26.2 degrees to 21.2 degrees with improvement in symmetry index from 42.7% to 76.0% (p = 0.025); and OC height asymmetry decrease from 5.7 to 1.8 mm (p < 0.001). Patients who did not undergo simultaneous RR realized no significant changes in NLF angle, upper lip slope, or OC height. Conclusions: RR performed alongside dynamic facial reanimation procedures helps to eliminate major asymmetry associated with FFP while awaiting restoration of facial function.
Eye-tracking provides an objective measure of how observers direct visual attention to presented stimuli and has become an increasingly valuable tool in facial plastic surgery. It offers unique insight into how facial conditions and surgical interventions impact facial attention. A well-designed eye-tracking study can address patient questions about how others look at their face, identify targets for visual improvement, and objectively assess facial plastic surgery outcomes. Significant variability exists in eye-tracking study design and execution within facial plastic surgery, often producing data that are erroneous, difficult to interpret, or not generalizable to clinical practice. There are currently no guidelines for the design of eye-tracking studies in facial plastic surgery. Furthermore, the technical requirements for facial eye-tracking studies differ from those for non-facial studies. This article aims to synthesize the existing literature and authors’ experience to establish basic guidelines for designing eye-tracking studies in facial plastic surgery. We hope this guide will help investigators design high-quality eye-tracking studies to drive meaningful advances in the field of facial plastic surgery.
