Static reconstruction for facial paralysis is mainly used for improving acute symptoms around the eyelid and symmetry at rest. Many procedures have been reported for each facial region. Proper treatment options should be selected by evaluating multiple factors such as duration of paralysis, age of the patient, and severity of the symptoms.
Static reconstruction is the major procedure for eyelid reconstruction, and reconstruction around the eyelid requires not only functional recovery from paralytic lagophthalmos but also cosmetic improvement for paralysis.
For eyelid reconstruction in acute cases, we think lower eyelid reconstruction using minimally invasive procedures, such as the Kuhnt-Szymanowski procedure, should be considered first, followed by evaluation for upper eyelid surgery.
In chronic cases, lower eyelid reconstruction should also be considered first；however, the procedures should be more stable using grafts of fascia or cartilage. Then, eyebrow lift is performed, especially when upper eyelid ptosis is marked due to redundancy of upper eyelid skin. Finally, we consider surgery for the upper eyelid on a case-by-case basis.
In this study, we describe our systemic algorithm for each facial region using representative cases.
