One problem of older patients (45 to 90 years of age) that should not be underestimated is the difficulty in breathing through the nose due to a bottleneck in the air flow in the nose (collapsed external nasal valve) caused by muscle atrophy. The introduction of autologous tissue can reopen it and normalize nasal breathing. At the same time, a symmetry adjustment of the entire half of the face is achieved at rest (without spontaneous facial expressions). Often the introduction of autologous tissue (e.g. connective tissue from the thigh as a static sling) is combined with other procedures, such as free muscle transplantation (dynamic restoration), in order to simultaneously create resting symmetry of the relaxed face. This is immediately noticeable to the patient as an immediate success after the operation.

This sprightly older gentleman complained before the operation about massively restricted nasal breathing on the right. Due to the lack of muscle tone in facial paralysis, the nostril also loses tension and the airflow is constricted. In addition to a dynamic muscle rearrangement (temporalis muscle transfer), the patient received a static suspension plasty of the right nostril to open the external nasal valve. The effect is positive for the patient immediately after the operation. The video is taken 10 days after successful surgery. Typically, there is still swelling and a slight bruising of the right half of the face.