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Facial Reanimation


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Facial paralysis can be temporary or permanent, and occurs when the nerves that control facial muscles are disrupted and cannot send a signal. It may be caused by Bell’s Palsy, autoimmune disorders, viruses, or other nerve or muscle conditions.

Our expert team uses surgical and nonsurgical treatments to support facial reanimation and relieve paralysis or synkinesis. Nonsurgical treatments  include Botox® and targeted facial neuromuscular retraining. Surgical options include rerouting or possibly removing nerves, removing muscles, or grafting (transplanting) facial muscles.

Who is a Candidate for Facial Reanimation?

If you have little or no smile movement, cannot blink naturally, or have abnormal or unwanted facial movement, you may be a candidate for facial reanimation surgery or other treatment.

Facial reanimation surgery can be very complex, and we have a high-volume facial nerve center that specifically focuses on facial paralysis.

If you are not a candidate for surgery, nonsurgical options may still be of great benefit to you. Additionally, we have specially trained physical therapists who can work with you to help you achieve optimal recovery.

What to Expect

Before the procedure

You will meet with your physician to complete an interview and examination to learn about your history and severity of facial paralysis. High-resolution photographs and videos will be taken to document how your paralysis impacts your facial expressions, such as blinking, puckering, natural smiles, and full smiles.

Because these are complex problems, you will typically have a combination of therapies, including Botox, and smaller procedures specifically tailored for individual issues, such as:

  • Eyelid weights for individuals with the inability to fully close the eye.
  • Lid tightening procedures for individuals with a loose lower eyelid.

We perform the full spectrum of advanced facial reanimation procedures, including:

  • nerve transfers
  • static suspension
  • free muscle tissue transfer to help build a smile from a completely new muscle
  • myectomy or denervation procedures for synkinesis

The timing of these procedures is important and requires the expert guidance that you will receive from UHealth.

Because some facial reanimation surgeries can take a longer time, you’ll likely go under general anesthesia (where your anesthesiologist will put you in a sleep-like state).

During the procedure

Your surgeon will create a well-hidden incision (cut) in your face to expose the nerve and muscles. Depending on your specific procedure, they may remove or graft muscles or reroute nerves. Our team of facial plastic and reconstructive surgeons work together daily on complex facial reanimation cases and can ensure the best and most efficient care possible. Surgeries vary greatly in length and can be as short as two hours to as long as eight to ten hours in particularly challenging or complicated cases.

Some facial reanimation surgeries are done as outpatient procedures, so you’ll go home the same day as your surgery. However, for complex surgeries and free muscle tissue transfers, your surgeon may recommend staying overnight in the hospital.

After the procedure

You may experience pain and discomfort at the surgical site. It may take two to three weeks to resume normal activities and a period of weeks to months to see results from your surgery depending on what procedure was performed. Some procedures involve the regrowth of nerves, and this process may be slow.

It may take more than a year to fully recover facial movement after surgery and therapy. You’ll see your surgeon regularly and physical therapy sessions will help retrain the muscles of your face after surgery

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