Paralysis of the face, often called Bell’s palsy, can be the result of a traumatic injury, surgery, tumors, stroke, or infection. No matter the cause, it can be a devastating condition for patients. The aesthetic, functional and psychological impact of facial paralysis cannot be overstated. Bradford A Bader, MD – Facial Plastic and Reconstructive Surgery is committed to assisting facial paralysis patients. We offer the latest and most advanced treatments and procedures to help restore the natural appearance and function of a paralyzed face.
Bell’s palsy is the term applied to cases of facial paralysis where there is no other obvious cause. It accounts for 85% of all cases of facial paralysis which makes it the number one cause of facial paralysis in this country. The cause is a virus that infects the facial nerve and causes it to swell within the bony canal it travels through to exit the skull. This leads to damage to the facial nerve and signals can no longer travel to the muscles of the face and results in the inability to move one side of the face. The paralysis in Bell’s palsy develops rapidly in a matter of hours or a few days and is noticed by patient as an inability to blink or smile and drooping of the lower face.
Patients with facial paralysis should be evaluated by a physician as soon as possible. The diagnosis of Bell’s palsy is only made when other potential causes have been ruled-out. Your physician might choose to order tests such as an audiogram, blood tests, CT scan and/or MRI depending on your specific history and physical examination. There are effective treatments for Bell’s palsy when it is diagnosed early, which often include short courses of high doses of steroids and anti-viral medications.
Fortunately, 70% of all Bell’s palsy patients will fully recover within 6-12 weeks. Paralysis that lasts beyond 12 weeks requires further investigation by your physician to rule-out other potential causes. The remaining 30% that do not completely recover can experience residual symptoms such as facial twitching, facial spasms, excess tearing, dry eyes, incomplete eye closure, obstruction of vision, nasal obstruction, inability to smile, facial asymmetry and facial drooping. All of these problems can lead to decreased self-confidence and depression.
As a facial plastic surgeon, Dr. Bader has a unique expertise in the diagnosis and treatment of facial paralysis. He offers many innovative non-surgical and surgical therapies to restore facial function and movement.
Muscle relaxing injections (Botox and Xeomin) can calm facial twitching and spasm.
There are many procedures aimed at protecting the eye and rehabilitating the eyelids. The inability to close the eye is often addressed by implanting a a tiny weight made of gold, titanium or platinum under the skin and muscle of the upper eyelid to help it close. The brow can droop and obstruct the vision and this is often corrected with a direct browlift. The lower eyelid tends to droop and can lead to excess tearing as the natural tears cannot drain through the tear duct efficiently. A lower lid tightening procedure is an effective method of restoring symmetry and function of the lower eyelid.
Nasal obstruction is a common complaint of patients with facial paralysis as the muscles that help keep the nostril open fail and cause the nostril to collapse. This can be addressed by inserting cartilage grafts and sutures to help stent the nostrils open. Most patients consider the lower face droop and inability to smile or purse their lips the most distressing consequence of facial paralysis. Many patients feel self-conscience about their appearance and tend to avoid social activities. They avoid eating in front of others because of the difficulty in keeping food and drink in their mouth. The inability to smile or purse the lips to give a kiss robs patients of the ability to physically exhibit spontaneous joy, love and emotion and takes a psychological toll over time.
These are several ways to improve the lower facial droop and appearance and function of the lips. These procedures include various techniques for re-suspending drooping tissue, the so-called “static” procedures, and the restoration of muscle function through various nerve grafting and/or re-routing techniques, the so-called “dynamic” procedures. Your candidacy for static and/or dynamic procedures is dependent upon various factors such as age, overall health, reason for paralysis, length of paralysis and the status of the facial nerves and muscles. Dr. Bader’s thorough assessment of your facial paralysis may also include imaging, such as CT or MRI, and studies of the electrical activity of your nerves and muscles to help determine your candidacy for the various procedures.
Dr. Bader would like all facial paralysis patients to know that they do not have to live with the paralysis forever and there are very effective treatments available. If you or a loved one has facial paralysis, please call Dr. Bader for a consultation to learn more about the rapidly advancing ability to restore facial appearance and function.