Is there any way to improve the appearance of the right side of my face (lazy eye) that's affected by Bells Palsy? (Photo)
Doctor Answers 6
Eyelid spasm after #bellspalsy
Thank you for your question. You have developed a condition called synkinesis. This is common after facial paralysis. The nerve fibers running to the different muscles in your face get erroneously rerouted when they regenerate during the recovery period. This results in activation of many muscles in your face when you only intended to activate a few muscles. Squinting when smiling is probably the most common complaint I hear from patients who have recovered from facial paralysis.
You do not have ptosis. Ptosis only involves the upper eyelid. Your photos nicely demonstrate that your right upper eyelid is lower than the left but also show that your right lower eyelid is higher than the left. This results in a smaller appearing eye. This is spasm and synkinesis and any eyelid surgery typically makes the problem worse.
The treatment is a small amount of Botox injected into the ring of muscle around your eye. This should only be performed by a physician highly trained and experienced in treating this condition.
I recommend seeing a physician with a special interest in treating facial paralysis to have this very simple, safe and effective treatment that will correct your problem.
Eye closing after Bells palsy
I would first try botox to relax the spastic muscles on the affected side. If that doesn't work, then you can consider eyelid ptosis surgery. See an oculoplastic specialist for evaluation.
What will improve my appearance
Thanks for the question. It would appear that you have a ptosis as a result of the Bell's palsy and this can be corrected by performing eyelid surgery. A full examination by a skilled Plastic Surgeon is always necessary. Perhaps limited facial fillers or surgery could also be recommended after an evaluation.
Good luck to you.
Frank Rieger M.D. Tampa Board Certified Plastic Surgeon
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Eye closure on smiling (synkinesis) - a common complication following Bell's palsy
Hi there. Thank you for posting your question. The problem demonstrated in your photo is common in recovering Bell's palsy patients - it is called 'synkinesis' and is due to abnormal recovery of nerve function resulting in uncoordinated muscle contraction. Specifically, when you smile, your right eye closes too - but when the nerve functions normally, you should be able to coordinate smiling and eye closure individually. It has nothing to do with having a lazy eye and certainly nothing to do with ptosis, which is due to a separate nerve all together. Unfortunately, patients with facial nerve injuries often get inappropriate advice from aesthetic surgeons with no experience in treating facial palsy. Synkinesis can be improved with a combination of physiotherapy to stretch the eyelid and botox in some cases - the key is to find a surgeon who specialises in facial palsy. Good luck!
Ptosis 2nd to Bells Palsy
Thank you for sharing your problem and question. Ptosis due to a non-resolving 7th nerve palsy can be easily corrected by an experienced Oculoplastic Surgeon. Good luck,
Ptosis and history of Bell's Palsy
It appears that you have ptosis on the right side. This is not related to Bell's Palsy, a problem associated with Cranial Nerve VII. Lifting the right upper lid would improve your eyelid symmetry. I would recommend evaluation by an oculoplastic surgeon who could check for residual VIIth nerve weakness and correct the ptosis. Your smile is great! So I doubt you have significant residual facial nerve palsy. Best wishes.
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