Is there anyway to prevent my eye from closing when I smile? (photos)

Question

Im now 44 but at 12 years old I was a passenger in a vehicle crash and was ejected from the vehicle through the front windshield. The glass cut me from the corner of my mouth all the way around below my ear to the back of my neck. My facial nerve was cut in half. I know have partial paralysis on the right side of my face due to the nerve damage. I can move my cheek up to smile but since the crash my eye closes when I do. Is there any way to stop my eye from closing when I smile?

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photo. When there has been a facial nerve injury, sometimes the nerve fibers will regrow and reconnect in an aberrant fashion -- meaning that the fibers connect to the wrong muscles. To some extent, this can be reduced by weakening certain overactive muscle groups. Typically this is done with Botox. Best of luck!

Stephen Weber MD, FACS · Answer

You seem to have healed very well from a severe facial injury. Botox can often be very helpful for the issue that is troubling you. Injections around the eye area can weaken the muscle to a degree that it doesn't close completely when you smile. However, it should still close when you consciously close your eye. The goal is improvement as opposed to complete reversal of this effect. With reasonable expectations you should be very happy with the results. Seek an experienced physician injector who has experience treating facial paralysis with Botox. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Christian L. Stallworth, MD · Answer

Bigmac02-  Thanks for your question.  You are dealing with a problem common to patients who have suffered a facial nerve injury - called synkinesis.  Botox injections strategically placed to weaken muscles around the eye can open the eye while leaving the more important functional muscles of the face in tact.  I treat many patients like your self.  An in-person consultation can help to identify the exact treatment needed to help in your case.  Best wishes!

Samuel Baharestani, MD, FACS · Answer

Wow, it seems like you've been through a lot.  You probably have some degree of aberrant nerve regeneration that is causing your eyelids to close when you smile.  Botox injections will likely improve your condition.  Schedule a consultation with a board certified oculoplastic surgeon to discuss the options that would be best for you.  Good luck!

Anand G. Shah, MD · Answer

Hi there.  Please understand that the definitive answer rests with an in-person evaluation and consultation.  At this stage, Botox may be an effective intervention for the symptoms described.  Hope this is helpful.  Best wishes.

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Is there anyway to prevent my eye from closing when I smile? (photos)

Answers (5)

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