Reconstruction of the paralyzed face with the polypropylene mesh template.

Several techniques for static suspension of soft tissues in facial paralysis are available, including this use of the polypropylene (Marlex) mesh template. Through a standard rhytidectomy, lip and melolabial incisions, this template can be attached to the pivotal facial suspension points to bring about a selective and adjustable redistribution of the facial soft tissues. Although not meant to replace autogenous tissue use or physiologic reanimation procedures, this technique proved to be useful in three selective cases. The functional and cosmetic consequences of the polypropylene mesh template insertion on both a model and on three clinical patients with unilateral facial paralysis illustrate this technique. The concept of facial suspension along with its limitations, especially as it relates to template use and static facial suspension, are discussed.