Spanish surgeons have performed a remarkable procedure that has allowed a man with facial paralysis to smile for the first time in 11 years.

Doctors in Navarre, northwest Spain, extracted muscle from the legs of Isidoro Bejarano, 37, and injected it into both sides of his face – a procedure that allows him to smile once more. “I am very happy. Before it was like I was wearing a mask, without any expression. Now if I want to laugh, I can do it,” Mr Bejarano said after the operation.

“Even though I can’t smile spontaneously, I can speak more easily and I have much more self-confidence.”

In 1997 Mr Bejarano, from Navarre, found that he could not close one eye and was given a diagnosis of cavernoma, a malformation of a vein in the brain or spinal cord. Facial paralysis is a side-effect of the condition. In July two teams of surgeons at the University Clinic in Navarre carried out the operation to restore movement to his face.

One team extracted two segments of muscle tissue from Mr Bejarano’s legs. A second team prepared each side of his face for the graft. The leg muscle was extracted with parts of vein, artery and nerves attached.

Bernardo Hontanilla, who led the plastic surgery team, said: “As the facial nerves were damaged on both sides of the face, the only option we had was to graft a new muscle on the face and attach the new nerve to allow this muscle to move. Afterwards, thanks to the plasticity [of the muscle] the brain will assimilate the new function of the muscle.”

Though the form of surgery has been carried out 15 times in Spain, few patients are suited to undergo the specialised operations.

Rafael Martin-Granizo, the president of the Spanish Society of Oral Surgery, said: “Not all patients can have this type of surgery. In some cases the facial nerves are incapable to send impulses and grafts will not work.”

Professor Juan Sebastián López-Arranz, of Oviedo University, said: “This is one of the possibilities for paralysis, as in cases of face transplants. There are many techniques, but almost none satisfy completely surgeons and patients. If they have managed this here, I am delighted for them.”

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