Keeping the fat on the right spot prevents contour deformity in temporalis muscle transposition.

The temporalis muscle transposition is a reliable, one-stage reanimation technique for longstanding facial paralysis. In the variation described by Rubin the muscle is released from the temporal bone and folded over the zygomatic arch towards the modiolus. This results in unsightly temporal hollowing and zygomatic bulging. We present a modification of this technique which preserves the temporal fat pad in its anatomical location, and conceals temporal hollowing and prevents zygomatic bulging.The data of 23 patients treated with this modification were analysed.