Correction of Unilateral Paralysis of the Lower Lip with the Koire-Sling

Injury to the marginal mandibular branch of the facial nerve has led to disturbing functional and cosmetic deformities. Difficulties with speech and eating have often been observed among patients displaying such injuries. The major concern of these patients is the resultant lower lip asymmetry apparent when the patient smiles. Numerous methods for correcting this deformity have been described, most of which require the trade-off of a prominent scar. These techniques are often objectionable to many of the younger patients. The purpose of this article is to describe a simple and effective method, using a suturing technique, to improve the cosmetic and functional problems associated with this condition. The method uses a 3-0 nylon suture, which is used to draw the corner of the lower lip inferiorly and laterally toward the periosteum of the inferior border of the mandible. Good cosmetic and functional results were noted.