Smile surgery: Turn that frown upside down

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DURHAM, N.C. (Ivanhoe Newswire) – A smile can brighten someone’s day, it’s a way to greet each other and it makes us feel good, but what if you couldn’t smile? For some people, it’s impossible. Their facial muscles don’t move. Now, surgeons are using state of the art techniques to get them smiling.

Grinning from ear to ear, your smile can light up a room—connecting you to others.

It’s an ability Abbie Honeycutt lost at age six. She had a brain tumor removed and lost function of her facial nerve.

“I didn’t smile a whole lot,” Abbie Honeycutt told Ivanhoe.

But thanks to a technique known as facial reanimation, Dr. Jeffrey Marcus was able to give Honeycutt her smile back.

“It’s giving people the ability to interact just like any other person, to smile like any other person,” Jeffrey R. Marcus MD, FAAP, FACS, Pediatric Surgeon, Plastic and Reconstructive Surgeon, Duke University Medical Center, told Ivanhoe.

Doctors can connect a nerve graft from the normal side of the face to the paralyzed side, or surgeons can use the nerve responsible for chewing to give you your grin back.

“It gives you a very, very strong kind of contraction for a smile,” Dr. Marcus said.

Also on the horizon is a robotic muscle.

“It is where this tiny little contraction device, which is like a synthetic muscle, is implanted,” Dr. Marcus said.

“Before I just wouldn’t talk,” Honeycutt said.

Now, she is beaming.

“Now, I am confident that I can smile,” Honeycutt said.

“It does keep getting stronger and so even where we are today isn’t going to be the end cause it will continue to get a little bit better,” Dr. Marcus explained.

“Smile surgery” isn’t just about making a person look better. Facial paralysis also impacts a person’s ability to feed themselves and speak.

BACKGROUND: Facial paralysis is loss of facial movement because of nerve damage. The facial muscles may droop or become weak. It usually happens on just one side of the face and can come on suddenly or can happen over a period of months. Depending on the cause, it might last a short or extended period of time. (Source:

CAUSES: According to the National Institute of Neurological Disorders and Stroke, Bell’s palsy is the most common form of facial paralysis. Every year, 40,000 people in the U.S. experience sudden facial paralysis due to Bell’s palsy. No one knows what causes Bell’s palsy, but researchers believe it may be related to viral infections of the facial nerve. However, most patients recover completely in about six months. Other causes of facial paralysis include:

• Stroke

• Skull fracture or injury to the face

• Head or neck tumor

• High blood pressure

• Ramsay-Hunt Syndrome—a viral infection of the facial nerve

• Autoimmune diseases—like multiple sclerosis, which affects the brain and spinal cord

• Chronic middle ear infection (Source: and the National Institute of Neurological Disorders and Stroke)

NEW TECHNIQUE: One nerve controls the muscles of the mouth, eyelids, forehead, and nose. When this nerve is damaged, all aspects of the facial expression, including smiling, are affected. Surgery can restore the ability to smile and also support those other muscles, to improve facial expression. One type of surgery being used to help correct facial paralysis is called facial reanimation, also called “smile surgery.” There are various types of procedures physicians use to plan a facial reanimation surgery. They may include:

• Nerve grafting – These procedures include moving nerves from different parts of the body to the face. By doing so, physicians can be assured that a patient will have more movement and sensation in their face, allowing them to better control the muscles.

• Muscle transfers – This involves moving tendons and muscles from one part of your body, usually the legs or abdomen to the face. Some of the tendons that are moved include the temporalis tendon transfer, digastric tendon transfer and the gracillis. (Source: and