Facial Reanimation
The highly skilled surgical team at Orlando Health Aesthetic and Reconstructive Surgery Institute provides surgical intervention for facial paralysis resulting from a variety of causes, including congenital defect, facial injury and tumor surgery. Orlando Health is the first in Florida and the only healthcare system in the Southeast to offer a full collection of complex facial reanimation surgeries for cancer patients experiencing both acute and chronic facial palsy. We provide comprehensive, multidisciplinary care that focuses on each patient individually using advanced microsurgical and reconstructive techniques that offer the best functional and aesthetic outcomes. Our team will be with you every step of the way on your journey to restored confidence and improved quality of life.
Causes of Facial Paralysis
Facial paralysis results from nerve damage, which can be caused by a variety of conditions, the most common being birth defects or neurological diseases such as a stroke, brain tumor and Bell’s palsy. Other possible causes of facial paralysis include:
- Congenital: Birth defects, Moebius syndrome
- Neurological: Stroke, Bell's palsy, multiple sclerosis, Guillain-Barré syndrome
- Infectious: Lyme disease, Ramsay Hunt syndrome, otitis media (middle ear infection)
- Traumatic: Skull fracture, facial injury, iatrogenic nerve damage (resulting from a medical treatment or procedure)
- Neoplastic: Brain tumors, neck masses, acoustic neuromas
Facial Paralysis Symptoms
The symptoms of facial paralysis can begin suddenly or come on gradually over a few months. They can include:
- Motor: Asymmetric smile, incomplete eye closure, inability to close lips to speak and swallow
- Sensory: Decreased tear production, sensitivity to sound, distorted sense of taste
- Functional: Difficulty speaking, drooling, difficulty with eating or drinking
- Psychosocial: Impaired emotional expression, decreased quality of life
Who Is a Candidate for Facial Reanimation Surgery?
To diagnose facial paralysis, your doctor may ask you to try to move muscles in your face, and the results will be documented to monitor for progress. You likely will be asked to perform these movements:
- Raising your eyebrow
- Closing your eye
- Smiling with no teeth showing
- Smiling with teeth showing
- Frowning
- Puckering
Your doctor also may order imaging, nerve studies or blood tests. Facial paralysis can be temporary or permanent, and the experts at Orlando Health Aesthetic and Reconstructive Surgery Institute can help you find the right treatment for your condition.
Facial Reanimation Treatment
If you experience total facial paralysis or near-total loss of facial muscle control, your doctor may recommend facial reanimation surgery. This type of treatment can be done in two ways, and the decision is based on the timing of the loss of function.
If you have had recent loss of facial control, transplanting nerves may be your best option. The new nerves may be able to take control of your facial muscles before they become permanently paralyzed. For those with long-standing facial paralysis, surgeons can transplant muscles to the face with microsurgery techniques. Both procedures restore the ability to better express emotions through natural movements of the face.
- Early Intervention (<1 year):
- Direct nerve repair
- Cable grafting, interposition nerve grafting
- Cross-facial nerve grafting
- Nerve transfers
- Late Intervention (>1 year):
- Free functional muscle transfer
- Regional muscle transfers
- Static procedures
- Adjunctive procedures (eyelid weights, facial slings)
Facial reanimation can be performed in one or two stages. If your surgeon recommends using two surgeries for your condition, they likely will be separated by 9-12 months. In making this decision, your surgeon will consider several factors.
Treatment Selection Factors:
- Time since onset of paralysis
- Patient age and health status
- Cause of paralysis
- Available donor nerves/muscles
- Bilateral vs. unilateral involvement
- Patient goals and expectations
