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Facial paralysis is a condition where there’s a loss of movement in the face because of nerve damage. This condition may affect one or both side of the face.

They can be a congenital condition or as an effect of trauma or disease. Facial paralysis can cause an imbalance of the face and asymmetrical facial expressions. It can be due to:

  • Bell’s Palsy
  • Stroke
  • Autoimmune diseases
  • Head or neck tumor
  • Skull fracture

The facial reanimation surgery (facial paralysis surgery) is a treatment option for those who had facial paralysis. The procedure aims to reanimate the patient’s facial deformity caused by the paralysis. This surgery is one of the most complex procedures of the facial reconstructive surgeries.

Facial Reanimation Surgery Techniques and Procedure

To effectively improve the facial symmetry and restore facial animation, you may undergo one specialized technique or a combination of techniques. Your surgeon will determine the right technique for you after checking your overall health. The options for facial paralysis surgery are categorized into static procedures and effective procedures.

By: Dr Azizzadeh
The type of technique for your facial paralysis may depend on the duration of the paralysis. It also depends on the restoration of the nerve function of the facial muscles.

Static vs. Dynamic Procedures

The static procedures for facial paralysis surgery like facial slings don’t do much restoration to your facial movements. They include suspensory surgeries that mainly hold the corners of the mouth in place and improve the closure of your lower eyelids.

Free A Person Massaging a Woman's Face Stock Photo

Here are the static procedures for total unilateral facial paralysis:

  • Facial plastic procedures
  • Static musculofascial transpositions
  • Static sling
  • Eyelid weights

Conversely, dynamic procedures will improve the lost mobility of facial muscles. Dynamic processes can’t only improve the position of your face and mouth. It’ll also recreate your smile through animation. Children with congenital facial paralysis are often conducted with dynamic procedures because of its ultimate results.

Here are the dynamic procedures for total unilateral facial paralysis:

  • Interpositional grafts
  • Direct facial nerve anastomosis
  • Dynamic free flap reconstruction
  • Dynamic musculofascial transpositions

The facial paralysis techniques may include:

  • Muscle Transfer – This procedure involves moving your muscles and tendons from one part of your body (legs or abdomen) to your face. The tendons may include the digastic tendon transfer, temporalis tendon transfer, and gracillis.
  • Nerve Grafting – This procedure involves moving nerves from various parts of the body to your face. It’ll ensure more movement and sensation on your face. Also, it’ll allow you to have better control in your facial muscles.

How much does facial surgery cost?

The facial paralysis surgery cost varies. Its estimated cost is $9,304 and may be more or less depending on several factors like:

  • Anesthesia
  • Surgeon’s fee (may differ, based on their experience)
  • Hospital facility costs
  • Medical tests
  • Post-surgery garments
  • Medications

Who are the candidates for facial paralysis surgery?

Facial paralysis surgery is for those who wish to improve their facial appearance and movements which were disfigured by paralysis. The candidates for facial paralysis or facial reanimation surgery are those who experience prolonged paralysis that has:

  • Ocular complications
  • Articulation difficulties
  • Impaired feeding
  • Difficulty in delivering emotions through facial expressions

How to choose your cosmetic surgeon?

A facial paralysis surgery must be done by a certified and expert cosmetic surgeon to accomplish the best results. An unqualified practitioner may lead to surgical complications and unsatisfying results. Your plastic surgeon should have a sound knowledge of the facial nerve anatomy.

Keep these factors in mind when choosing a surgeon for your facial paralysis surgery.

  • Certification and Memberships. First of all, make sure that a surgeon is certified by the American Board of Plastic Surgery. Memberships may not be necessary, but it could be a great indication that your surgeon is well-skilled.
  • Experience. A surgeon’s experience can tell well if he can give you a safe and satisfying facial paralysis surgery.
  • Reputation. One way to find an excellent plastic surgeon is by seeking a recommendation. If you know someone who went through a facial paralysis surgery, ask them. Check the doctor’s record for any malpractice complaints. This information may be made public by state medical boards.

How to plan for the procedure?

If you’ve chosen the best surgeon that you can trust for the procedure, the next step should be the consultation. Your doctor will ask about the cause and duration of your facial paralysis. He’ll go through your overall health, physical and mental, to make sure you’re fit for the procedure.

There’ll be certain medications your surgeon won’t allow you to use to prevent excessive bleeding. You also have to inform your doctor if you have any allergies, especially with anesthesia. A month before the operation, you may need to stop smoking (if you smoke). This is to ensure proper wound healing.

Prepare a leave from work for at least two weeks or more, and arrange someone for your aftercare and recovery.

What happens after the facial paralysis surgery?

The recovery time for a person who went through a facial paralysis surgery may differ on certain factors. It differs if whether you’ve received one or more procedures, your age, and the duration of your paralysis.

Usually, static procedures don’t require an admission in the hospital. You can go home right after the surgery. But if you’ve undergone dynamic procedures like nerve grafting, it may be necessary for you to stay in the hospital for a couple of days.

Your plastic surgeon may prescribe you with pain medications and antibiotics. The medications will help you recover from facial paralysis surgery successfully.

The key component to achieve the optimal results of facial paralysis surgery is to engage in a facial nerve rehabilitation therapy. You’re going to need a trained facial physical therapist to help you adjust after the surgery.

If there are any significant postoperative instructions from your surgeon, make sure to follow them. Don’t forget to visit your surgeon from time to time.

What are the results of facial paralysis surgery?

The primary goal of this surgery is to achieve a more symmetrical face, and that’s the result you’ll get after the procedure and recovery time has passed. It aims to enhance the ‘quality of life’ of adults and children who suffer from physical, mental, and emotional suffering from paralysis.

If you’ve gone through static procedures, you’ll surely have an improved appearance. It restores the symmetrical look of the face. These procedures won’t reanimate your facial movements.

If you’ve gone through dynamic procedures, it’ll help reanimate your facial movements and improve your appearance, too.

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