[Plastic surgery in patients with facial palsy].

In short-term irreversible paralysis caused by facial nerve problems the aim is to re-innervate the paralysed facial musculature. Whenever a paralysis remains untreated for longer than 12-18 months successful re-innervation is unlikely. In longer-term paralysis the symmetry of the face at rest can be restored by a static procedure, a skin resection or a fascial suspension for example. Restoration of movement in the paralysed side of the face is possible by means of a dynamic procedure. For many years the temporal muscle and the masseter muscle have been used to improve the position of the mouth and closure of the eye. Spontaneous laughter can again be made possible by using a muscle from elsewhere in the body (e.g. the gracilis or possibly pectoralis minor) and attaching it to the nerve supply of the opposite side of the face.