Masseteric Nerve Transfer for Facial Reinnervation

The masseteric nerve is commonly used for zonal reinnervation of the midface, specifically for smile rehabilitation, given its minimal harvest morbidity and natural course in close proximity to zygomatic and buccal facial nerve branches. The nerve to the masseter muscle can be used to innervate free muscle flaps transferred for facial reanimation; it can be used to replace the main trunk of the facial nerve after injury to restore resting facial tone, and it can be coapted to a distal zygomatic branch of the facial nerve for dynamic smile rehabilitation. Herein, the surgical steps of masseteric nerve transfer for facial reinnervation are detailed.