title: Ancillary procedures in facial animation surgery.
abstract: OBJECTIVE
  Facial animation surgery with neuromuscular transplants has become a standard procedure for the treatment of facial palsies. However, the forehead, periocular complex, nasal base area, and inferior lip are secondary sites that also need to be considered in the complete rehabilitation of a flaccid facial palsy.
  
  
  METHODS
  A total of 136 ancillary procedures were performed in 49 patients between 2003 and 2013 and consisted of eyebrow suspensions (11), upper eyelid loading with a platinum chain (39), inferior palpebral suspension with fascia lata (22), nasal base suspension with fascia lata (26), and botulinum toxin injection (38).
  
  
  RESULTS
  Cosmetic results were good and excellent in 30.7% and 63.2% of the procedures, respectively. Functionally, periocular complex rehabilitation and nasal base suspension led to excellent improvements in function in 87.2% and 73.1% of the patients, respectively.
  
  
  CONCLUSIONS
  The use of ancillary procedures can improve the functional and esthetic results of facial animation surgery.
authors.affiliation: Chief Assistant, Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Bianchi
authors.affiliation: Chief Assistant, Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy. Electronic address: a.ferri@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferri
authors.affiliation: Associate Professor, Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: Resident, Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Leporati
authors.affiliation: Associate Professor and Division Head, Otolaryngology Head Neck Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Teore
authors.initials: T
authors.lastname: Ferri
authors.affiliation: Full Professor and Division Head, Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Sesenna
mesh_terms: D005145:Face / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies