Facial Reanimation Surgery Chicago

What is Facial Paralysis?

The facial nerve is essential for facial expression and the ability to smile. People can be born without facial nerve function on one or both sides of the face (congenital facial paralysis, such as Moebius Syndrome,) or the facial paralysis can be caused by trauma, tumor (such as parotid tumors, acoustic neuromas,) illness or infection such as Bells palsy. The facial paralysis can be complete or partial and the treatment options may vary based on the underlying cause and the severity of the condition.

What is Facial Reanimation?

Facial reanimation can restore the ability to smile for those who have lost their smile due to illness or trauma and it can make it possible for people to express themselves who never before were able to do so. The restoration of facial expression and a beautiful smile takes several steps and can include nerve transfers/grafts, transfer of viable muscle from another area of the body as well as additional procedures to protect the eye (gold weight placement) and improve speech and oral competence.

Facial reanimation procedures refer to interventions that restore facial symmetry, resting tone, voluntary movement or a combination of these. The surgical approach depends on the exact condition, timing and extent of the facial paralysis. It involves reinnervation techniques, muscle transfers local or free, and static procedures.

Facial Reanimation Techniques

Reinnervation techniques involve cross facial nerve grafts, hypoglossal nerve transfers (Babysitter procedure) or direct nerve grafts.

Muscle transposition techniques include local muscle transfer (temporalis sliding myoplasty, masseter transfer) or microvascular free functional muscle transfer (gracilis muscle.)

Static Reanimation procedures include fascia lata slings for symmetrization of smile and nasal airway improvement as well as oral competence. Brow lift and asymmetric facelift can furthermore enhance symmetry at rest.

Restoring eye closure: the inability to close the eye (lagophalmus) and the lack of muscle tone around the eye can lead to exposure and dryness of the eye. Initial treatment consists of artificial tears and lubricants as well as protective eye taping. If the ability to close the eye does not return, surgical placement of a gold weight is a more permanent solution.

Contralateral procedures/synkinesis: relative hyperactivity of the normal side can be addressed with botox injections for more symmetry. Synkinesis or facial spasm on the affected side can also respond to botox injections or selective nerve transaction.

Who Performs Facial Reanimation?

Dr. Seitz from Loren S. Schechter, M.D. Plastic Surgery works closely with neurologists, speech therapists, and physical therapists to provide a coordinated effort to patient care.