title: Refinements in nasolabial fold reconstruction for facial paralysis.
abstract: OBJECTIVE
  The objective of this study was to describe a methodology for creation of a nasolabial fold in patients with facial paralysis and to report patient-reported outcome measures following this procedure.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  All patients who underwent nasolabial fold modification at our institution since July 2010 were included in our analysis. Patient demographics and characteristics of their facial paralysis were noted. Preoperative Facial Clinimetric Evaluation scores were compared with postoperative scores to quantify outcomes. Pre- and postoperative photos were then presented to an observer for ratings of overall midfacial appearance.
  
  
  RESULTS
  Thirty-one patients were included in the review. Most of the patients were male. The average onset of paralysis was 50 years, and the average age at time of surgery was 61 years. The majority of patients had flaccid paralysis, with 10% of patients having synkinesis. Most patients presented with complaints of oral incompetence or drooling and generalized facial asymmetry. Facial Clinimetric Evaluation scores (P < .004) and overall midfacial appearance (P < .05) improved significantly following surgery.
  
  
  CONCLUSIONS
  The nasolabial fold is an important aesthetic component of the face commonly affected in patients with facial paralysis. We demonstrate quantitative improvement in quality of life scores and aesthetic appearance following nasolabial fold refinement and describe the procedure in depth.
  
  
  METHODS
  4.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otology and Laryngology, Harvard Medical School/Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Prabhat K
authors.initials: PK
authors.lastname: Bhama
authors.forename: Jong G
authors.initials: JG
authors.lastname: Park
authors.forename: Kerry
authors.initials: K
authors.lastname: Shanley
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Facial paralysis; facial nerve; nasolabial fold; reanimation