Facial Reanimation Surgery

The Rush Approach to Facial Reanimation

Facial reanimation surgery, sometimes called "smile surgery," is commonly used to treat facial paralysis caused by a brain tumor, Bell's palsy, trauma or another cause. Facial paralysis or weakness can profoundly affect the way you function and interact with others. This can include losing the ability to smile, an important way people express themselves. Facial reanimation procedures can help improve or even restore normal facial movement.

Not everyone with facial paralysis needs facial reanimation. The paralysis can improve in time, without any treatment, though it is still important to see an expert to find the cause of your facial weakness.

We may recommend facial reanimation in these instances:

• You don't fully recover on your own.
• Nonsurgical treatments (e.g., steroids, Botulinum toxin injections, physical therapy or occupational therapy) aren't effective.

Is Facial Reanimation Right for Me?

Not everyone is eligible for facial reanimation. These are some reasons why you might not be a good candidate:

• You have severe physical debility or a serious health condition.
• You are too old or frail.
• Too much time has passed since the paralysis occurred.

Personalized Surgical Treatment

We tailor surgical treatment to each patient for optimal results. Your personalized facial reanimation plan may include one or more of the following:

• Nerve grafting, in which we take nerves from another part of the body and surgically implant 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 we transplant or move muscles from another part of your body — usually leg, neck or jaw muscles. These are some common muscle transfer procedures:
  • Temporalis tendon transfer
  • Digastric tendon transfer
  • Gracilis smile restoration. Unlike other muscle transfer procedures that only enable a slight raising of the corners of the mouth, gracilis muscle transfer can actually restore a person's ability to smile.

Alternatives to Facial Reanimation

If we determine that facial reanimation is not right for you, you may have other options. Static reconstructive procedures are often used for people who can't undergo facial reanimation (which is also known as dynamic reconstruction).

While they do not provide facial reanimation, static techniques can at least help restore facial symmetry (evenness), including addressing issues with the eyes and eyelids (which dynamic procedures cannot do).

Static procedures include the following:

• 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

Static procedures may also be used in combination with dynamic procedures. We will discuss all of these procedures with you, as well as the potential risks of surgery.

Rush Excellence in Facial Reanimation

• Expertise you can trust: Because no two people are alike, we create a personalized approach for each patient to help improve facial movement and appearance. We are committed to helping you achieve the best possible results, so you can live life to the fullest.
• Advanced treatments: Rush 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.
• Continuum of care: Because Rush is an academic medical center, our patients have access to all of the resources and support services they may need, including inpatient and outpatient physical, occupational therapy and speech therapy. And Rush's Magnet-recognized nurses are here to provide exceptional care and support throughout treatment and recovery.