Endoscopic-assisted free muscle flaps for facial reanimation

Endoscopic assistance can be utilized to improve the cosmetic results of free muscle flap, smile restoration surgery. The technique facilitates provision of the surgery via a limited preauricular approach avoiding the traditional submandibular-cervical incision. Enhanced visualization also facilitates proper suture anchoring of the muscle flap to the orbicularis oris, avoiding unwanted lateral displacement and a malpositioned nasolabial fold. The superficial temporal artery and vein are the preferred recipient vessels. The microsurgical nerve repair is frequently performed before the microvascular anastomosis to accommodate for the more limited exposure.