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        Facial Paralysis

        What is Facial Paralysis?

        Facial paralysis is a condition in which the muscles of the face are weak or unable to move, causing an inability to control facial expressions and difficulties with eating, drinking, and speaking. It can also cause a loss of sensation in the affected area.

        Symptoms

        The symptoms of facial paralysis can vary depending on the cause and severity of the condition, but common symptoms may include:

        • Weakness or inability to move certain facial muscles, such as those used for smiling, frowning, or raising the eyebrows
        • Difficulty speaking, eating, or drinking
        • Difficulty closing the eyes or blinking
        • Dry eye or eye irritation due to a loss of tear production
        • Changes in the appearance of the face, such as an uneven smile or a drooping eyelid
        • Loss of sensation in the affected area
        • Pain or discomfort in the face or head

        Causes

        Facial paralysis can be temporary or permanent and is caused by a variety of factors, including:

        • Trauma
        • Infection
        • Inflammation
        • Neurological disorders

        Risk Factors

        Many cases of facial paralysis are caused by unknown factors and may not be associated with any specific risk factors. If you are concerned about your risk of developing facial paralysis, it is important to speak with a medical professional for more information. There are several factors that may increase the risk of developing facial paralysis, including:

        • Age: The risk of facial paralysis increases with age, particularly in people over the age of 60.
        • Gender: Men are more likely to develop facial paralysis than women.
        • Medical history: People who have a history of ear infections, neurological disorders, or head and neck trauma may be at increased risk of facial paralysis.
        • Certain medical conditions: Some medical conditions, such as multiple sclerosis, Bell's palsy, and Guillain-Barré syndrome, can cause facial paralysis.
        • Certain medications: Some medications, such as antibiotics, anticonvulsants, and chemotherapy drugs, can increase the risk of facial paralysis.

        Diagnosing Facial Paralysis

        To diagnose facial paralysis, your doctor may conduct a physical examination, including your facial movement and vision, and a neurological exam.

        During the physical examination, the doctor will assess the strength and movement of the facial muscles, as well as sensation in the affected area. They may also examine the ears, nose, and throat to check for any abnormalities that may be contributing to the paralysis.

        Imaging tests, such as an MRI or CT scan, may be used to get a detailed view of the facial nerves and any other structures in the head and neck that may be contributing to the paralysis. These tests can help the doctor determine the cause of the paralysis and plan the appropriate treatment. In some cases, additional tests, such as electromyography (EMG) or nerve conduction studies, may be necessary to further evaluate the extent and cause of the paralysis.

        Treatment for Facial Paralysis

        In many cases, facial paralysis can be improved or resolved with treatment.

        Treatment for facial paralysis depends on the cause. You may be treated with physical, speech, or occupational therapy. In some cases, facial plastic surgery may also be recommended to improve the appearance of the face or for facial reanimation.

        Facial Reanimation Surgery

        Facial reanimation surgery involves taking nerves, muscles, or tendons from other parts of the body and transplanting them into areas of the face to restore function. This surgery can involve:

        • Nerve transfers: harvesting a nerve from the leg and transplanting it into the area of the face affected by paralysis.
        • Tendon transfer: similar to nerve transfers in that it involves moving a facial tendon to a new position to help with facial positioning and function.
        • Gracilis muscle transplant: taking a portion of the gracilis muscle from the inner thigh and transplanting it to the affected area of the face. This transplant can be used to help a person smile.  A benefit of this procedure is that it does not require teeth clenching in order to smile.

        Recovery time will depend on the type of procedure. Nerve transplantation surgery recovery may involve a few days in the hospital and will likely involve physical, occupational, or speech therapy as you learn to use the reinnervated area of your face. Muscle transplantation surgery recovery may take longer than nerve transplantation procedures. 

        Synkinesis After Facial Paralysis

        After recovering from facial paralysis, some patients may experience synkinesis—a condition where voluntary movements, such as smiling, cause involuntary movements in other facial muscles, like eye closure. This occurs due to miswiring during nerve regeneration. Understanding and addressing synkinesis is crucial for restoring natural facial movements.

        For more detailed information on synkinesis and its treatment options, please visit our Synkinesis page.

        Our Doctors

        At the Institute for Advanced Reconstruction, our team of surgeons are specialists in complex nerve, muscle, and tendon surgeries. Using cutting-edge microsurgical techniques, we give hope to patients who previously believed they were out of options. 
        Joseph Dayan
        Physician

        Joseph Dayan

        MD, MBA
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        Zuhaib Ibrahim
        Physician

        Zuhaib Ibrahim

        MD, FACS
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        Matthew Kaufman
        Physician

        Matthew Kaufman

        MD, FACS
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        Chris Lakhiani
        Physician

        Chris Lakhiani

        MD, FACS
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        Tushar Patel
        Physician

        Tushar Patel

        MD, FACS
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        Insurance Information

        The Institute for Advanced Reconstruction participates in a wide range of insurance plans, including those listed below. However, each physician has their own accepted insurance and hospital affiliations. Before scheduling an appointment, please contact your insurance carrier to confirm that your provider is in-network.

        If we are not an in-network provider, our friendly insurance specialists will help you find the most coverage available for your treatment. 

        • Horizon Blue Cross Blue Shield of New Jersey
        • Medicare
        • Railroad Medicare
        • Aetna
        • Cigna
        • United Healthcare
        • Oxford (Freedom, Liberty)
        • MagnaCare
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        Patient Resources

        Learn more about what to expect when it comes to surgical procedures and treatments at the Institute for Advanced Reconstruction by visiting our patient resource page. 

        Resources

        Am I a candidate for Nerve Surgery?

        Eligibility for facial paralysis treatment will depend on which areas of your face are affected. Schedule a consultation today to find out if you qualify for advanced procedures like nerve transplant surgery. 

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