Implantable and Prosthetic Devices for Dynamic Facial Reanimation: A Scoping Review

Importance:This review aims to assess the current landscape of implantable and prosthetic devices for dynamic facial reanimation. Evaluation will include mechanisms, reported effectiveness, and clinical feasibility. Observations:This scoping review included 34 primary studies published since 2000, focusing on prosthetic and implantable devices for dynamic facial reanimation. Four major categories emerged: electromyography–functional electrical stimulation (EMG–FES) systems, artificial muscles, electromagnetic actuators, and wearable prosthetics. Most research addressed periocular reanimation, particularly blinking, and several studies discussed midface and smile restoration. EMG–FES systems were the most represented and robust across animal in vivo models. Artificial muscle, electromagnetic actuators, and wearable prosthetics mostly remain in theoretical stages. Conclusions and Relevance:Although not yet fully viable, implantable and prosthetic devices show potential to complement or one day replace current surgical approaches to facial reanimation. EMG–FES systems offer the most viable near-term options. Clinically, these technologies may offer customizable, dynamic facial movement restoration, especially for patients with limited surgical options. Continued innovation and long-term safety studies will be essential.