By modifying a muscle transplant operation, Johns Hopkins surgeons report they are able to restore authentic facial expressions of joy — wide and even smiles — to selected patients with one-sided facial muscle paralysis due to birth defects, stroke, tumors or Bell’s palsy.

“The smile has been judged as the most important sign to express positive emotions, and people are judged to be angry when they can’t smile,” says Kofi Boahene, M.D., associate professor of otolaryngology-head and neck surgery and dermatology at the Johns Hopkins University School of Medicine. “Previously, the best we could hope for most of the time with surgery was a smirk where just the corners of the mouth upturn in a smile like the one Mona Lisa has in DaVinci’s famous painting. But that isn’t a joyful, expressive smile where the lips move up, teeth show and eyes narrow. Now we’re able to really restore a true smile.”

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