Facial Paralysis

Facial paralysis is the inability to move one or more muscles in the face due to damage or swelling of the facial nerve, or brain damage in the area of the brain that controls the facial muscles. Facial paralysis can have a serious impact on your daily life. Even simple pleasures, like having a conversation with a loved one or enjoying a meal, can be challenging.

Our highly skilled experts offer compassionate, cutting-edge care for people of all ages who experience facial paralysis and weakness due to illness or trauma. This includes advanced surgical procedures that can improve both your appearance and your ability to do things like smile, open and close your eyes, eat, drink and talk.

You may see specialists from several areas, including facial plastic and reconstructive surgery, neurotology, neurology, audiology, speech-language pathology, neurosurgery, physical therapy and occupational therapy. Depending on your condition, you may not need all of these specialists; like your treatment plan, your care team will be tailored to you.

Our team has expertise in treating even the most complex cases, and we welcome patients seeking second opinions. 

Effects of Facial Paralysis

This condition can cause a variety of issues that profoundly affect the way you function and interact with others, including the following:

• Changes in your appearance, such as drooping on one or both sides of your face
• Problems fully opening or closing your eyes; eye dryness or tearing
• Inability to express emotion, especially smiling
• Difficulty eating or drinking
• Impaired speech
• Muscle twitching
• Ringing in one or both ears (tinnitus)

Bell's palsy, while rare, is the most common form of facial paralysis or weakness. It occurs when the facial nerve — which transmits signals from your brain to the muscles of your mouth, nose, eyelids and forehead — becomes swollen, inflamed or compressed.

Causes of Facial Paralysis

These are some reasons why you may experience facial paralysis or weakness:

• Brain tumor
• Diabetes
• Head or neck tumor, such as acoustic neuroma, that puts pressure on the facial nerve
• High blood pressure
• Infection in or around the brain
• Lyme disease
• Multiple sclerosis, Guillain-Barre syndrome or another autoimmune disease
• Physical trauma, such as a skull fracture
• Trauma during childbirth (in newborns)
• Sarcoidosis
• Stroke

Depending on the cause, the paralysis can occur suddenly. For instance, stroke and Bell's palsy will produce immediate weakness or paralysis. Paralysis resulting from tumors typically develops over time.

Facial Paralysis Treatment at Rush

Because facial nerve disorders are life-altering, affecting many functional and emotional aspects of your life, care at Rush goes beyond the OR. Our experts are dedicated to helping you regain facial movement and symmetry, as well as cope with the psychosocial effects of facial paralysis.

Sometimes, facial paralysis goes away on its own. For example, newborns with childbirth-related paralysis almost always recover completely without any treatment.

If the paralysis does not get better, depending on the cause, your doctor may refer you for further treatment, which could include the following:

Nonsurgical treatment: This may include steroids, botulinum toxin injections or Botox (to ease involuntary muscle twitching, which sometimes also happens in people with facial paralysis), physical therapy, occupational therapy, or speech therapy.

Surgical treatment: If you don't fully recover on your own or with nonsurgical treatment, surgery can often help restore facial symmetry and function — including your ability to smile and fully close your eyes. At Rush, we will tailor surgical treatment to your unique needs for optimal results. Your plan may include one or more of the following:

• Facial reanimation surgery to help improve or bring back your smile:​
  • Nerve grafting, in which surgeons take nerves from another part of the body and surgically implants them in the face. This helps to restore both movement and sensation, so you can better control your facial muscles. Techniques include masseter-to-facial nerve transfer.
  • Muscle transfer, in which surgeons transplant or move muscles from another part of your body — usually leg, neck or jaw muscles. The newest type is gracilis smile restoration. Unlike other muscle transfer procedures that only enable a slight raising of the corners of the mouth, gracilis muscle transfer can restore a person's ability to smile. Rush was one of the first health systems in the U.S. to offer gracilis smile restoration.
• Other procedures to improve your appearance and facial movement:
  • Blepharoplasty, or eyelid lift.
  • Eyelid weight surgery, in which surgeons place tiny implants in the upper eyelids to enable you to close your eyes completely.
  • Brow lift to keep your upper face symmetric, as well as prevent or correct difficulty with vision.
  • Static lift, similar to a face-lift, to restore symmetry to your face.
  • Synkinesis treatment, which involves selectively stopping muscles from twitching, or unwanted movements.
  • Platysmaplasty, to treat tight and painful contractures (abnormal shortening of the muscles that prevents normal movement) that sometimes occur in the neck.

Rush Excellence in Facial Paralysis Care

• A comprehensive approach to facial nerve disorders: Because facial nerve disorders are life-altering, affecting many functional and emotional aspects of your life, care at Rush goes beyond surgery. Our team of experts is dedicated to helping you regain facial movement and symmetry, as well as cope with the psychological effects of facial paralysis.
• Expertise you can trust: Plastic and reconstructive surgeons at Rush have extensive experience treating facial paralysis and will personalize a treatment plan for you.
• Cutting-edge treatments: Rush offers a full range of surgical options, and was one of the first centers in the U.S. to offer gracilis smile restoration — a surgical procedure that can restore a person's ability to smile after facial paralysis. We offer all of the latest facial reanimation procedures and techniques, including dual innervation and selective neurectomy. 
• Highly ranked specialty programs: Rush University Medical Center's ear, nose and throat program, with facial plastic surgeons who treat facial paralysis, is ranked among the nation's best by U.S. News & World Report.