The bow-tie mattress suture for the correction of nasal cartilage convexities and concavities.

is essential to all clinicians involved in facial paralysis rehabilitation. To advance the field in such a niche subspecialty, it is essential that outcomes are reported uniformly. In addition to the creation of a “global” database, standardizationof smileanalysiswould further thisgoal.Toachieve widespread acceptance, the system needs to be simple, intuitive, and inexpensive. Itmustbereproducibleacrossdifferent international centers, and requires strong interrater and intrarater correlation. We believe the SMILE system is valid and satisfies these criteria. To our knowledge, it is the onlysmileanalysis techniquethatpermits remotemeasurement of digitally transmitted photographs. This development alone represents an improvement for patients, who often travel long distances for review of smile excursion, andforsurgeons,whocannowanalyzesmileoutcomewithout the patient physically present. It also provides a useful tool for retrospectivephotographic facialanalysis.Comparingpreoperative topostoperativechange inmeasuredparameters from rest to smile may be the most useful determinant of successful facial reanimation surgery.