Recommended Procedure to Treat Droopy Face and Paralysis?

I had a acoustic neuroma surgery that left my right side of my face droopy. Also paralyzed that side. Is there anything a doctor can do to help with this? It's been 3 yrs. since my surgery.

Thanks,
Teresa

Doctor Answers (5)

Facial paralysis following neurosurgery

+1

Facial paralysis can result following neurosurgical tumor resection, as in your case.  The degree of paralysis may vary extensively.  It is difficult to tell how much of your paralysis is causing your facial droop, asymmetric smile, or asymmetric eye closure.  Assuming you have complete absence of movement on half of your face, you can undergo a variety of static and/or dynamic procedures to restore lost function and symmetry.  I typically like to use dynamic options whenever possible.  For example, for a paralyzed smile, I like to use a 2-stage reconstruction using a cross face nerve graft to bring in the missing stimulation from the normal side, followed by a free gracilis muscle flap to deliver movement to the corner of your mouth.  Most other options tend to be static and less aesthetically appealing.

 

A note on eye closure...numerous procedures can be performed to restore the symmetry of the eyes and to protect the eyeball itself.  In my experience, most options currently available result in undercorrection and persistent asymmetry or functional dryness of the eye.  The point is that experience of the plastic surgeon is key.  It is important to know how aggressive to be in correcting deformities related to facial paralysis in order to have a lasting result. I typically perform a lower eyelid tendon sling procedure with or without an upper eyelid platinum weight insertion.  In my experience, this has been the most reliable and permanent solutions to this vexing problem.


Pasadena Plastic Surgeon
5.0 out of 5 stars 1 review

Facial Paralysis Treatment (after Bell's Palsy or Acoustic Neuroma Removal)

+1

Hi Teresa,

Living with facial paralysis can be one of the most difficult things for patients to experience.  There are multiple procedures that can be performed to treat this condition.  

The most important thing is to provide adequate eye protection.  This is usually accomplished with an upper lid weight and a lower lid tightening procedure.  In addition, patients often require blepharoplasty and brow lift to help address the droopiness to the upper face.

The midface is often the most troubling aspect for patients.  After all, this is where we smile and restoration of this simple function can be one of the most important and satisfying parts of treatment.  This is often accomplished through transfer of other muscles (usually the muscles are taken from the face or other parts of the body, such as the leg or arm).  In addition, treating the middle part of the face can help restore the ability to speak and eat and improve the ability to breathe through the nose.  In addition, facelifting can very much be helpful to improve facial symmetry.

An often overlooked area of treatment is the mouth and chin.  Patients often have asymmetry of the lower lip that can be treated by addressing the muscles on the non-paralyzed side of the face.  This is typically done through resection of those muscles or through botulinum toxin injection.

Speaking of botulinum toxin injection, treating the face with these injections can help restore symmetry and decrease the incidence of abnormal facial movements (synkinesis).

Finally, seek the care of a qualified facial nerve physical therapist.  This therapy can be extremely important in your recovery.

I wish you luck!

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Treatment for droopy face and paralysis

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Paralysis of the side of the face is a very challenging problem to deal with in facial reconstructive surgery. As long as it has been several years since the surgery and there is no chance of the facial nerve re-growing, it would be acceptable to undergo facial reconstructive procedures now. Static and dynamic forces are in play in a partially paralyzed face and this make it very difficult to make perfect. A totally paralyzed face is only static and a unilateral facelift can be done to improve facial skin tone.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Facial paralysis and droopiness

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Hi Teresa,

I understand that pictures are static and that paralyses are difficult to catch sometimes. The facial nerve and facial muscle function is a multifaceted dynamic set of events. The full extent of your paralysis and the reconstructions required to address your functional and cosmetic needs can only be determined during a face to face consultation. Acoustic neuroma resections are usually done at large tertiary care, university hospitals. There should also be a plastic surgeon on staff at the institution who can address your needs. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Surgical Reconstruction of Facial Paralysis / Bell's Palsy

+1

The reconstruction of Facial paralysis is a very specialized field in Plastic surgery. It is usually treated by several groups of operations
- STATIC SLINGS - the droopy side is lifted with a variety of "cables" to match the face at rest but cannot animate normally.

- FUNCTIONAL repairs - here, depending on the function of your facial muscles they may be
a. innervated by cable grafts across the face from the normal (left side) to the right in an effort to re-innervate (neurotize) these muscles
b. your temple muscle (temporalis sling) on the left may be flipped over and attached to corners of the mouth and eyes so you can simulate a smile by biting down.
c. if your facial muscles have wasted, muscles from your thigh or forearm with their blood supply and nerves can be transferred microsurgically to the right face and hooked in such a way that your face can become RE-ANIMATED and be close to normal.

The greatest surgeons specializing in these operations are Dr. Julia Terzis in Norfolk, Virginia and Dr. Ronald Zucker in Toronto, Canada.

Good Luck.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.