Facial paralysis has different causes. In a simple way it can be due to brain affections, as in cases of brain vascular accident or tumors, or to facial nerve affections. The most frequent type is Bell’s palsy, which is due to inflammation of the facial nerve, often associated with viral infections. Other frequent causes are facial nerve injuries during surgeries of the middle ear or the parotid gland.
If you are going to perform surgery that could partially compromise the facial nerve, an immediate reconstruction can be planned. In cases of total irreparable nerve involvement, a facial resuscitation surgery can be performed in the same tumor resection surgery, or neurotization with nerve grafts.
A special group of patients are those with congenital facial paralysis as in the case of patients with Goldenhar syndrome.
The treatment will be determined depending on the cause, the time of evolution and the vitality of the affected facial muscles.
Facial neurotization with nerve grafts
In cases where the facial muscles are vital, neurotization can be performed using nerve grafts to the contralateral facial nerve or other motor nerves.
Minimally invasive one-stage facial resuscitation surgery
It is done when the affected facial muscles can no longer be used.
Traditionally this surgery is performed in 2 stages, with 2 surgeries separated in time. Our confrontation is to perform surgery in a single surgery, which achieves the same results, but decreases surgical times, reduces scarring improving the aesthetic result, decreases donor areas since it is not necessary to use nerve grafts and reduces costs.
Briefly, surgery involves the transfer of a small segment of a muscle of the back (latissimus dorsi), to replace the function of damaged facial muscles. This is done among other things with the help of a microscope to reconnect the blood vessels and muscle nerve transferred to the face. This procedure is a highly complex surgery that must be performed by a certified microsurgeon, with training in Facial Reanimation to ensure the best possible result.
Eye resuscitation in facial paralysis
The lagophthalmos that occurs in facial paralysis is a difficult problem to solve. It can lead to corneal dryness, ulcerations and even blindness. Our confrontation with this problem is to perform a muscle transfer that allows the patient to close the eye voluntarily. This surgery does not involve the placement of foreign bodies in the eyelid as gold weights.
Reconstructive Microsurgery and Aesthetic Surgery
I have always thought that reconstructive surgery makes me a better cosmetic surgeon and that cosmetic surgery makes me a better reconstructive surgeon.
In this case of facial paralysis, we combine concepts of facial aesthetic plastic surgery and reconstructive microsurgery, achieving a natural and harmonious recovery of our patient’s smile.
Facial Reanimation Surgery
Facial Reanimation Surgery:
When facial paralysis does not recover spontaneously, it is possible to smile again thanks to Facial Resuscitation Surgery. Our challenge is to perform this highly complex surgery in a minimally invasive way, with fewer scars and in a single stage.
Recover the smile (Facial paralysis)
We want to share with you the result of the surgery in one of our patients with facial paralysis (right side). Our patient is 1 year old and suffered a dog bite on his face. After a complex exploration and reconstruction of the facial nerve, he managed to recover his smile.