FACIAL PARALYSIS

Permanent facial paralysis can result from trauma, cancer, previous facial surgery, or infection.  Because the facial muscles are responsible for one’s facial expressions, speech, eye closure, and eating, facial paralysis can be a devastating condition.  Depending on the cause, severity, and timing of the facial paralysis, Dr. Kim will use one or more of a variety of surgical techniques to treat the problem.

Several separate, but related problems may afflict the facial paralysis patient. These problems are typically treated with specific individual surgical procedures.  These surgeries may be performed during the same operation or may be performed separately depending on the needs of the patient.  The following summarizes the common problems and treatments related to facial paralysis.

Inability to the close the eye

This serious condition is caused by paralysis of the muscle that closes the eye combined with sagging of the lower facial muscles which cause the lower lid to pull down.  Treatment involves placement of a small weight under the skin of the upper eyelid so that it will close passively with gravity.  The lower lid can be surgically elevated to compensate for the sagging facial tissue.

Sagging corner of the mouth

As the lower facial muscles progressively sag due to loss of muscle tone, the corner of the mouth may pull downward, causing drooling, difficulty with speech, and an asymmetric appearance.  Dr. Kim can accomplish elevation of the facial tissue through suspension of the muscle under the facial cheek and lip skin through suspension with sturdy tissue taken from the muscle sheath around the thigh muscle. Alternatively, the muscle in the temple which aids in chewing (generally not affected in facial paralysis), may be transferred into the lower face to elevate the tissue around the mouth.

Nasal obstruction

Paralysis of the facial muscles can lead to inability to keep one of the nostrils open during breathing.  Suspension procedures used to elevate the corner of the mouth can also be applied to open the nostril.

Facial Asymmetry

One of the most devastating aspects of facial paralysis is the asymmetry caused by sagging tissue on one side of the face.  Elevation and suspension of the sagging facial tissue, eyelid, and mouth can greatly improve upon such conditions.

Other procedures

Numerous other procedures are available for the treatment of facial paralysis.  These include nerve grafting, resection of paralyzed muscle, face lifting, selective Botox® treatment, or browlifting.

David W. Kim, M.D., FACS, is a double board certified facial plastic surgeon specializing in facial cosmetic surgery and other procedures, especially nose surgery, or rhinoplasty, in San Francisco at his office in the Union Square area. Dr. Kim’s office provides a full range of surgical and non-surgical rejuvenation and appearance enhancing procedures, including Botox® cosmetic injections, Restylane®, and Radiesse®, laser hair removal, IPL photo facial rejuvenation, facelift surgery, and skin treatments in San Francisco.

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