Thus, the learning ability (plasticity) of the brain contributes to a natural smile if this operative method is chosen., Many patients can consciously distinguish between the activation of the masticatory muscle and the activation of the mimetic musculature after this operation procedure.
Disadvantages of this method can be synkinesis (unintentional mass movements) during the chewing process, e.g. a slight smile or winking of the eyes when chewing during food intake. The movements are often only very subtly visible, so that in practice there are no problems worth mentioning in everyday life and the patients cope well with them. Spontaneity and emotional coupling are not as reliable with V-to-VII transfer as with CFNG, where the facial nerve of the healthy half of the face functions as the donor nerve.
Murphy et. al were able to show in a study that V-to-VII transfer is associated with low morbidity. This study also showed that an average time of 5.76 months is required after a V-to-VII transfer until reinnervation occurs and dynamics and resting tone of the face are restored.
Reinnervation by cross-face nerve transplants (CFNG) is slower, but is functionally much more specific with appropriate selection of donor nerve branches. Since "current", i.e. nerve fiber capacity, is lost on the long distance between both halves of the face, we very often combine both procedures. Thus, we carry out V-to-VII nerve transfer as well as nerve grafting with two CFNGs in combination. In this way, the "best of two donor nerve regions" can be meaningfully combined in terms of selectivity of the desired functions and muscle strength through high axon capacity ("current strength").