I have an unbalanced face from Bell's Palsy. I am especially disturbed by the look of my eyes. (photo)

I heard that Botox might be an option. Is that true?

Doctor Answers 9

I have an unbalanced face from Bell's Palsy. I am especially disturbed by the look of my eyes.

Botox, if injected properly by a board certified plastic surgeon can help the appearance of fFacial paralysis from a condition like Bell's Palsy, The botox helps to relax the muscle of the symmetrical area to help balance our the highs and lows of movement. Good luck!

Providence Plastic Surgeon
4.9 out of 5 stars 63 reviews

Surgical And Nonsurgical Treatments Of Bell's Palsy

Bell's palsy is a condition around which there is frequently a great deal of confusion, so it is a good question to tackle.  Basically, the condition can be addressed by weakening the muscles of the unaffected side of the face in order to create greater symmetry, or by lifting the tissues of the affected side.  If the Bell's palsy is of short duration, it can frequently abate spontaneously, so temporizing measures such as injection of Botox on the contralateral side may be a reasonable option during this period.  

However, if the palsy is of long standing duration, then procedures directed at improving the affected side, such as brow lifting, blepharoplasty, surgical sling procedures, or even  microvascular transfers of innervated muscle flaps to return some element of animation to the affected side may be reasonable options.  With longstanding Bell's palsy, there is also frequently associated an element of volume loss, as well, and this may be addressed with fillers, fat transfers or flaps.  Certainly, Bell's palsy is one of the most frustrating and idiopathic phenomena with which we deal, but it can also be one of the most gratifying surgical corrections we can perform 

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 47 reviews

I have an unbalanced face from Bell's Palsy. I am especially disturbed by the look of my eyes.

Hello Easr,

When it comes to Bell's palsy Botox can be helpful for certain issues.  It can help to relax the good side to even things out a bit.  It can help if you are having synkinesis (trying to smile causes your eye to close).  It can help with spasms causing prominent muscles, especially in the neck.  Other treatments for Bell's palsy include surgical procedures to better improve symmetry at rest and other surgical procedures to help regain motion depending on when the injury happened.  It is best to follow up with a facial plastic surgeon for this type of treatment/evaluation.

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Facial assymetry

From the photos it appears you would benefit from Botox injections but be sure you see a board certified dermatologist or plastic surgeon and is experienced in the use of Botox.

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

Facial Paralysis

Thank you for your question, and I am sorry to hear about your struggle with facial paralysis.

Botox may have some effect on your facial asymmetry and as long as you go to an experienced injector, there is no harm in trying this as a first step. 

Given your pictures however, I think that surgical correction may give you the best and most lasting result.  The most common procedures performed around the eyes for facial paralysis are brow lift and blepharoplasty, (which can be done on one side only, or asymmetrically to lift the paralyzed side more) and lower eyelid tightening procedure.  

I'd recommend seeing an oculoplastic surgeon, or a facial plastic surgeon trained in facial paralysis for a full evaluation and to learn about your options before committing to any treatment. 

Best of luck,

Dr Rodman

Regina Rodman, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Bells palsy and improving eyes

You have tremendous volume loss around the eyes and would benefit from filler. There is laxity and brow ptosis too. Botox can help elevate the brows too. Other procedures such as Infini, CO2 laser, and even surgery might give further benefit.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Bell's Palsy

From your picture, it is difficult to tell exactly what the issue with your eye is. Most of the time in Bell's Palsy, the forehead can be droopy, which further pushes down on the eye and eyelid.  Unfortunately, during animation of the face, the brow either does not respond, or responds less.  To accurately determine your problem, you need to see a qualified surgeon, and possibly have a visual field test, as well.

Jesse E. Smith, MD, FACS
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 26 reviews

Botox and facial paralysis

Botox is commonly used to treat facial asymmetries caused by facial paralysis. Often times, the best results are seen when Botox is combined with fillers in patients with facial nerve palsy. These treatments do require advanced injection techniques and so I recommend you see a physician with considerable Botox experience.

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 58 reviews

Treatment options for Bells Palsy

Bells palsy is a really frustrating condition, it is no surprise you are bothered by it. We treat over 100 patients per year in our practice with this problem. You are right, that many times we see great benefit from Botox or Dysport. So I encourage you to see someone experienced with this condition, because you can likely get some help. Best of luck!

Patrick J. Byrne, MD, FACS
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 18 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.