A U.S military doctor performed the country’s first temporalis tendon transfer in March, restoring the facial movement and symmetry of a patient who suffered from facial paralysis.

The new procedure is designed to advance an existing reconstructive technique that improves the affects of facial paralysis including a drooping mouth, nasal obstruction, inability to close the eye, drooling, and more.

Bethesda’s chief of facial plastic and reconstructive surgery, Ifepo Sofola, who performed the surgery on Vietnam War veteran Dennis Tomasko, said there are several procedures used to treat facial paralysis. Temporalis tendon transfer and similar procedures involve muscle transfers, nerve repair to reconnect facial nerves or produce new nerves, and free tissue transfers, which use muscles and nerves from other parts of the body.

“The temporalis tendon transfer is a marked improvement in the management of facial paralysis and facial reanimation procedures,” Sofola said. “The force and direction of pull is better in this procedure than it was with others…and [the procedure] gives a markedly superior aesthetic result.”

However, facial paralysis treatment options are dependent on a number of factors including the type of nerve injury, the prognosis for recover, and the time of the injury, among other things.

“The nerve procedure only works if the nerve is caught within one year of the injury and when the neuromuscular junction is still intact, and no atrophy or fibrosis has set in,” Sofola said.

Sofola performed temporalis tendon transfer on Tomasko as well as a combination of other procedures to restore his facial paralysis including a bilateral brow lift, a mid-face lift, and weight implants to help close the eye.

“These were…procedures to create facial symmetry, and activity to ultimately improve Tomasko’s life,” Sofola said. “We can help people…coming back from war, as well. What we do is very necessary and can enhance the lives of the people we treat.”