Static sling surgery (Fascia lata sling)

In order to improve the resting symmetry or “tone” of the face, a time-tested treatment for facial paralysis involves resuspending the corner of the mouth with tissue taken from the thigh.  This procedure can be performed alone in order to treat facial droop, or in combination with facial reanimation surgery, such as the Masseteric nerve transfer.  In this procedure, tissue from the leg (fascia) is removed from the thigh through a surgical incision. Fascia is a form of connective tissue that wraps around muscles and is shown in Figure 1.  This tissue is then sewn underneath the skin of the face to the corner of the mouth and used to lift it. It is suspended underneath the skin to the soft tissue in the temple region.  This provides relatively quick improvement in facial symmetry, speech, and helps keep food and drink in the mouth effectively.

Figure 1: illustration of the Fascia lata in the thigh.  It is the white covering that is highlighted with a red arrow.

Is this procedure for me?

This surgery is relatively straightforward and the benefits of it are realized rapidly after surgery once the swelling subsides. The downside of this surgery is that no movement is restored to the face.  Also, the fascia will stretch with time and therefore there will be some recurrent droop to the corner of the mouth in the years following the surgery. The fascia lata sling may be used in combination with other facial reanimation techniques, such as the nerve to masseter transfer.  A Fascia lata sling can be used at any point after facial paralysis.  Lastly, fascia lata surgery can cause some pain and discomfort in the leg during recovery from surgery.  This typically subsides several months after the procedure.