What You Need To Know: Facial Paralysis and Rhinoplasty

What You Need To Know: Facial Paralysis and Rhinoplasty

Facial paralysis involves a loss of voluntary movement of the muscles and nerves in the face. If you suffer from this condition, you may not be able to move your eyebrows, lips, or other muscles on your face. Facial paralysis can affect your ability to smile and your overall appearance. If you or someone you love has this condition, the Johns Hopkins team of experts can help you restore facial muscle balance, symmetry, movement, and smile.

  • Symptoms of facial paralysis include muscle sagging on one side of the face, weakness, and inability to move the muscles on one side of the face. Paralysis is usually linked to damage to one of the skull's nerves, which controls all facial movements.
  • If you cannot blink, raise your eyebrows, smile, or express emotions with your face, you almost certainly have a facial paralysis. Lack of treatment can lead to serious eye damage, and we are also well aware that these symptoms can make you feel insecure about your physical appearance. 
  • Other symptoms of facial paralysis that you may also notice are drooling speech disorders and nasal obstruction.

  • Your facial paralysis may have been caused by an acoustic neuroma (a benign tumor better known as a vestibular schwannoma), Bell's palsy (an unexplained incident of muscle weakness or facial nerve palsy), a carotid gland tumor, or traumatic injuries.
  • If you have not been able to move one or both sides of your face since you were born, what we have is what we call congenital facial paralysis. This can affect people of any age, even children and the elderly.
  • A physical exam will help your doctor determine if you have a facial paralysis. To rule out brain or nerve tumors, stroke, and infections as possible causes of paralysis, you may have MRI and CT scans.
  • Treatments for facial paralysis vary. At Johns Hopkins, we design a treatment plan for each patient that may include one of these variants: physical therapy, injectable solution therapy, minimally invasive surgery, microsurgical techniques, and other surgical procedures.
  • The type of treatment your doctor will use to help you regain movement in your face will depend on how long you have been paralyzed and on the condition of your facial muscles, whether they have completely atrophied.

Surgical Techniques To Effectively Treat All Phases Of Facial Paralysis:

Muscle transfer: This technique involves the transfer of muscles from one part of the body to another — usually from the face, neck, or leg — toward the face. Some of the muscles and associated tendons that are frequently transferred are the temporal, digastric, and gracile (gracillis).

The nerve graft: This technique includes the transfer of nerves from different parts of the body to the face to ensure that you can have greater movement — and even sensitivity — in the face, which will allow you to have better control of your facial muscles. These may include the masseteric nerve graft, a crossover nerve graft, and the hypoglossal nerve graft to the facial nerve.

Eyebrow and Eyelid Repair: If you have a droopy eyelid so severe that it clouds your visual field, our surgeons can relocate it to repair your eye's function and appearance. If you can't blink, or have a hard time blinking, they can insert a small platinum chain into your eyelid so you can close and protect your eye. They can also do a nerve graft to regain the eye's sensitivity, and it can be protected.