What is facial paralysis or facial palsy?

Facial palsy or facial paralysis is the partial or complete weakness of the facial muscles.

Generally, facial paralysis or facial palsy occurs on only one side of the face. In rare cases, it may occur on both sides of the face.

Facial paralysis can have a significant impact on a person’s quality of life. It can lead to social isolation and depression.

Symptoms of facial paralysis or facial palsy

The symptoms of facial palsy may occur suddenly and vary depending on the extent and location of the paralysis. Facial palsy may cause:

• Mild weakness to total paralysis on one side of your face
• Facial droop and trouble making expressions
• Drooling
• Pain around the jaw
• Pain in or behind your ear on the affected side
• Sensitivity to sound on the affected side
• Difficulty speaking
• Difficulty eating and drinking
• Excessive tearing

Causes of facial paralysis or facial palsy

Facial paralysis or facial palsy can be caused by many things, including:

• Bell’s palsy: This is the most common type of facial palsy. Though the exact cause of Bell’s palsy is not known, most believe it is caused by damage to the seventh cranial nerve, which controls the muscles of the face.

• Facial trauma: Facial palsy can be caused by trauma to the face, such as a car accident or a fall.

• Tumors: Facial palsy can be caused by tumors that press on the facial nerves.

• Infections: Facial palsy can be caused by certain infections, such as Ramsay Hunt syndrome, which is caused by the varicella-zoster virus.

If someone is suffering from facial paralysis that is either permanent or not expected to improve in the short term, he or she may be advised to undergo facial paralysis treatment.

What treatments are involved in Facial Paralysis Repair Treatment?

There are several different treatments involved in facial paralysis repair. The treatment aims to protect the eye, provide symmetry at rest, and provide movement to the paralyzed muscles, while the ultimate goal is to restore involuntary, independent, and spontaneous facial expressions. The treatment plan you have will depend on the cause and severity of your facial paralysis, the presence of a proximal facial nerve stump, and the time elapsed since the paralysis began.

Facial paralysis repair treatment may include:

1. Brow Ptosis Correction
2. Lid Lag Correction
3. Lower Eyelid Retraction
4. Nasal Airway Repair
5. Commissure And Upper Lip Reanimation
6. Lower Lip Correction

Brow Ptosis Correction:

Brow ptosis is drooping of the eyebrow. If the patient suffers from brow ptosis, Dr. Arun Jeedi may recommend a brow ptosis correction or brow lift surgery.

How is Brow Ptosis Correction performed?

Brow lift surgery is a procedure where the eyebrows are lifted to a higher position on the forehead.

1. Direct brow lift: This type of brow ptosis correction involves making an incision in the skin above your eyebrow and lifting the eyebrow into a higher position.

2. Endoscopic brow lift: This type of brow ptosis correction involves making small incisions in the hairline and inserting an endoscope (a small camera) to guide the surgery.

Recovery & post-operative care for Brow Ptosis Correction

After a brow lift, there will generally be some bruising and swelling. There may also be some itching and numbness around the incisions. These symptoms should resolve within a few weeks.

If the incisions are covered in bandages, Dr. Arun Jeedi will likely remove them in one to three days. Sutures typically will be removed within seven to ten days after the surgery.

What are the risks associated with Brow Ptosis Correction?

As with any surgery, there are risks associated with a brow lift. These risks include bleeding, infection, and numbness or loss of sensation in the forehead. In case of bleeding or numbness, these complications are temporary. Dr. Arun Jeedi will prescribe antibiotics for prevention or treatment of infection.

Lid Lag Correction:

Lid lag is a condition where the eyelid does not fully close. If the patient has lid lag, Dr. Arun Jeedi may recommend a lid lag correction.

How is Lid Lag Correction performed?

Correcting a lid lag involves various methods to help the upper eyelid close fully. The method that is right for the patient will depend on the severity of the lid lag.

1. Gold weight lid lag correction: This type of lid lag correction involves surgically placing a small gold weight in the upper eyelid to help it close fully. Eyelid gold weights are available in a range of sizes and weights to ensure that each patient receives the ideal weight. The gold eyelid weight is designed to assist the eyes in closing only through gravity and weight.

2. Temporalis transfer: This type of lid lag correction involves taking a muscle from the temple area and attaching it to the eyelid to help it close fully.

3. Eyelid springs: Eyelid springs or palpebral springs are tiny metal springs that repair damaged eyelid function. In this type of lid lag correction, an eyelid spring is surgically attached to the eyelid to help it close fully. This allows the patient to blink normally without conscious effort.

4. Tarsorrhaphy: Tarsorrhaphy is a procedure that involves surgically stitching the eyelid partially closed. This reduces the size of the opening and not only makes it easier to close the eyes, but it also protects the eye from dryness and injury.

Recovery & post-operative care for Lid Lag Correction

After a lid lag correction, there will generally be some bruising and swelling. There may also be some itching and numbness around the incisions. But these will fade away in some time. It is necessary to attend the follow-up appointments with Dr. Arun Jeedi after the surgery so that he can ensure that there are no complications.

What are the risks associated with Lid Lag Correction?

There are risks associated with lid lag correction, like all surgical procedures. These risks include infection, bleeding, and poor wound healing. However, these complications are rarely seen and can be easily and safely treated by Board-certified surgeon Dr. Arun Jeedi .

Lower Eyelid Retraction:

If facial paralysis has caused the lower eyelid to droop or fall, Dr. Arun Jeedi may recommend lower eyelid retraction surgery to improve eye function.

How is Lower Eyelid Retraction Surgery performed?

Lower eyelid retraction surgery is performed to lift and tighten the lower eyelid of the patient.

1. Tendon sling surgery: In this surgery, a tendon graft, usually from the wrist, is taken and anchored to the upper and outer edge of the lower eyelid, thus lifting the eyelid and securing its raised position.

2. Lateral canthoplasty: A lateral canthoplasty is a common technique for shortening and tightening elongated and droopy lower eyelids. In this procedure, the eye’s outer corner (the lateral canthus) will be lifted and reshaped.

3. Temporalis transfer: In this surgery, a muscle from the temple area is taken and transferred to the lower eyelid to improve its function.

4. Cartilage graft: This type of lower eyelid retraction surgery involves taking a piece of cartilage from the ear and grafting it onto the lower eyelid. This graft will act as a support and help improve the function of the lower eyelid.

Recovery & post-operative care for Lower Eyelid Retraction Surgery:

The stitches will have to be removed five to seven days after surgery. The swelling of the eyelids usually goes away within the first week. There may also be some bruising, but it should also improve within the first week. To ensure proper healing, it is necessary to take it easy for the first four weeks after surgery. This means no heavy lifting, contact sports, or aerobic exercises. Most patients take three to seven days off from work.

What are the risks associated with Lower Eyelid Retraction Surgery?

Bleeding (hematoma) and infection are possible risks of lower eyelid retraction surgery. However, these complications are rare and can be easily and safely treated by Dr. Arun Jeedi .

Nasal Airway Repair:

Facial paralysis may sometimes cause nasal obstructions, which leads to difficulty in breathing from the nose. In this case, Dr. Arun Jeedi will recommend nasal airway repair.

How is Nasal Airway Repair performed?

Nasal airway repair is a surgery to improve the airflow through the nose. It is done by correcting any blockages in the nasal passages.

1. Alar base elevation: The alar base is the bottom part of the nose, including the tip, nostrils, and the area connecting the nose to the lips. During an alar base elevation, the skin around the nostril is lifted, and the soft tissue (cartilage and mucous membrane) is repositioned. This allows for easier breathing.

2. Septoplasty: In a septoplasty, Dr. Arun Jeedi will correct any deformities in the septum, which is the thin wall of cartilage and bone that separates the two nostrils. This will improve airflow through the nose.

3. Thread lift: A thread lift is a minimally invasive procedure in which dissolvable sutures are used to lift and reposition the soft tissue of the nose. This will improve the appearance of the nose and also help with the airflow.

Recovery & post-operative care for Nasal Airway Repair:

After the surgery, Dr. Arun Jeedi typically recommends taking at least three days off before resuming work.He also advises patients against doing any heavy lifting since this might damage the nose’s shape through straining.

One week after surgery Dr. Arun Jeedi will remove all casting materials and splints. The swelling after the surgery typically lasts for two to three weeks but can last up to two months in rare circumstances. To help reduce the swelling, Dr. Arun Jeedi will re-apply tape to areas that will be there until the second follow-up visit.

What are the risks associated with Nasal Airway Repair?

There are always risks associated with any surgical procedure. The risks specific to nasal airway repair include infection, bleeding, and poor wound healing. Most of these complications are rare and can be easily treated by Dr. Arun Jeedi .

Commissure And Upper Lip Reanimation:

The commissure is the corner of the mouth. Facial paralysis can cause the commissure and the upper lip to become unresponsive, making it difficult to smile. Dr. Arun Jeedi would suggest correcting this with surgical procedures to reanimate the commissure and upper lip.

How are Commissure And Upper Lip Reanimation procedures performed?

Commissure and upper lip reanimation procedures will either use nerve transfer or muscle transfer to allow the patient to smile again.

1. Nerve transfer: Nerve transfer is a procedure in which Dr. Arun Jeedi will take a healthy nerve from another part of the body and connect it to the facial nerve. This will allow the facial nerve to send signals to the commissure and upper lip and improve their function, thus restoring the smile.

2. Microneurovascular muscle transfer: In microneurovascular muscle transfer, Dr. Arun Jeedi will take a healthy muscle from another part of the body and connect it to the facial nerve. This will allow the facial nerve to send signals to the transplanted muscle and restore the smile.

3. Masseteric nerve transfer: The masseter is a large muscle in the jaw and the masseteric nerve is a large nerve in the cheek that activates it. In masseteric nerve transfer, Dr. Arun Jeedi will combine the masseteric nerve to the buccal branch of the paralyzed facial nerve by sewing them together under microscopic magnification. This will allow the masseteric nerve to send signals to the paralyzed nerve and reanimate the smile.

4. Temporalis transfer: In this surgery, a muscle from the temple area is taken and transferred to the commissure to animate it. This will help restore the patient’s smile.

Recovery & post-operative care for Commissure And Upper Lip Reanimation:

After the surgery, patients are generally told to avoid applying pressure to their faces for some time. Patients may be requested to perform various facial exercises after the operation. Swelling and bruising might occur immediately after surgery, although these symptoms usually go away within a week. The first two weeks at home should be taken easy, with a soft diet and no heavy lifting, and no vigorous brushing of teeth.

The results of the reanimation treatment can be seen over several months following the procedure. It is essential to attend the follow-up appointments with Dr. Arun Jeedi so that he can keep track of the reanimation process.

What are the risks associated with Commissure And Upper Lip Reanimation?

As with any surgical procedure, there are risks associated with commissure and upper lip reanimation. These risks include infection, bleeding, and poor wound healing. Most of these complications are rare and can be easily treated by Dr. Arun Jeedi .

Lower Lip Correction:

Due to facial paralysis, the lower lip may either become hyperactive or the muscles responsible for depressing the lower lip can lose function. Both can lead to an asymmetrical smile. Dr. Arun Jeedi can correct this problem with lower lip correction treatments.

How is Lower Lip Correction performed?

There are two ways in which Dr. Arun Jeedi can perform lower lip correction:

1. By weakening the hyperactive depressor muscles to bring permanent balance to the lips
2. By reanimating the weakened depressor muscle to restore its function

The appropriate procedures will be determined based on the patient’s case.

1. DLI & DAO excision: The depressor labii inferioris (DLI) muscles move the lower lip down to expose the bottom teeth while smiling. The depressor anguli oris (DAO) muscle moves the corner of the mouth during frowning. These muscles need to be weakened through surgical removal of muscle fibers to restore a symmetrical smile.

2. Botox: Botox works by temporarily weakening the muscle it is injected into. By injecting Botox into the hyperactive muscles, Dr. Arun Jeedi can bring symmetry to the lips and improve the patient’s smile.

3. Jaw or neck muscle transfer: In some cases, it may be necessary to transfer a healthy muscle from the jaw or neck area to the lower lip. This will reanimate the depressor muscles and restore the smile.

Recovery & post-operative care for Lower Lip Correction:

Patients are generally advised to avoid pressing their faces for some time after surgery. After the operation, patients may be instructed to perform various face exercises. Swelling and bruising may appear immediately after surgery, although they generally subside within a week. The first two weeks at home should be spent gently, with a light diet and no strenuous tooth brushing, and no heavy lifting.

The results of the lower lip correction treatment can be seen over several months following the procedure. It is essential to attend the follow-up appointments with Dr. Arun Jeedi so that he can keep track of the process.

What are the risks associated with Lower Lip Correction?

Infection, poor wound healing, and bleeding are possible after surgery, as with all types of surgical procedures. However, these complications are rare and can be easily and safely treated by Dr. Arun Jeedi .