Treatment Options
There are treatment options for every patient - from physical therapy to non-surgical care to advanced facial reanimation surgeries.
Treatment choices are highly individualized to each patient and situation. A comprehensive consultation is needed to determine which options may be best for you - but it is never too late to seek out treatment options.
This is a specialized type of physical therapy designed specially for patients with facial paralysis and synkinesis. There is excellent research that supports the use of facial nerve therapy in most patients with facial movement issues. It is particularily helpful in helping to treat tightness and cramping in certain areas of the face.
The inability to move your face normally has obvious implications on your daily functioning and life. It is normal to have feelings of sadness, anxiety, and depression. That is why we feel that it is critical to have mental health specialist integrated into our practice to help you manage these feelings.
Botulinum toxin is a well studied medication that temporarily weakens the muscle where it is in injected in the body. Doctors can use this medication in the face and neck to selectively weaken certain muscles to help restore symmetry, reduce spasms/tightness, and improve function. The medication generally last about 3 months before needing re-injection. When used for facial paralysis, it often can be submitted to your insurance plan for coverage (but this varies based on your specific insurance plan).
In some cases, a surgeon can help restore symmetry and function of your face by borrowing other head and neck nerves including a chewing nerve (Masseteric Nerve), a tongue nerve (Hypoglossal Nerve), and/or a facial nerve from the normal side of your face (Cross Facial Nerve Graft). Your candidacy for these procedures depends on the timing and cause of your paralysis.
For some patients with long-term facial paralysis, the best option to restore movement to the face is “building” a new facial muscle. Surgeons borrow a muscle from the inner thigh and transfer it to your face to build a new smile muscle. A consultation is needed to determine if this type of procedure would help you.
In select patients with a history of facial paralysis who develop synkinesis, there might be muscles in the face that are too tight or not moving correctly. Surgeons can identify certain branches of the facial nerve that are causing this tightness and dysfunction and selectively remove those branches. This can reduce tightness, improve symmetry of the face, and help some patient move their face in a more coordinated fashion.
Facial paralysis can change the position of the eyebrow and limit the ability for patients to close and protect their eye. There are a wide variety of surgical procedures that can be performed to help patients close their eye and change the position of the eyebrows depending on the timing of your paralysis and expectation for recovery.
We love to partner with our patients to figure out ways to help based on your specific concerns. Our head and neck and facial plastic surgery background gives us the experience we need to be creative in certain situations. Please do not hesitate to reach out to us to see if we can help.
In some patients with synkinesis - abnormal movements of the face after facial paralysis - there are muscles in the face that are too tight or no longer working in coordination. Your surgeon can selectively removal a small portion of certain malfunctioning muscles. This may help some patients have improved symmetry and function of their face.