Inclusion Criteria:

• Patients with unilateral facial paralysis scheduled for smile reconstruction using free gracilis muscle transfer driven by one of four neuronal inputs, specifically, the trigeminal nerve (nV), a cross-face nerve graft (nVII), dual innervation combining the trigeminal nerve, a cross face nerve graft, and patients who have midfacial modifications that involve performing direct coaptation between the trigeminal nerve and a branch to the native zygomaticus major muscle (5-7 transfer) and selective neurolysis in which several facial nerve branches that innervate muscles antagonistic to the smile animation are transected.
• Patient/parent interest/willingness to participate in the study
• An ability to comprehend verbal instructions
• An age range of 18 to 75 years

Exclusion Criteria:

• Presence of a major facial deformity/condition either congenital or acquired e.g. hemifacial microsomia, cancer
• Facial movement disorders due to primary muscular dysfunction or hemifacial spasm in the absence of synkinesis
• Mental or hearing impairment to the extent that comprehension or ability to perform the tests is hampered