Rewiring faces: advances and outcomes in facial nerve reconstruction after facial vascularized composite allotransplantation

FN reconstruction in FVCA is feasible and often results in partial functional recovery. However, outcomes remain heterogeneous and are influenced by surgical approach, immunologic status, and rehabilitative support. Standardized assessment tools should be more widely adopted to improve comparability and guide individualized treatment planning. Translational research and multicenter data collection are needed. FN reconstruction represents both a clinical challenge and an opportunity to improve long-term quality of life in FVCA recipients. Systematic Review Registration: identifier CRD420251029430.