Facial Reanimation

Facial paralysis or Bell’s palsy is a profoundly challenging experience. Our mission is to help individuals regain self-confidence and enhance their quality of life. We focus on preventing eye complications, reconstructing facial movement, restoring a dynamic smile, and enhancing facial aesthetics, all while prioritizing patient needs. We are deeply committed to enabling our patients to live life fully and eagerly anticipate providing care. 

What is Facial Reanimation?

Facial reanimation involves surgical interventions intended to restore movement to the face. There are two types of surgeries for facial paralysis or palsy: 

• Static Restoration: Aims to make both sides of the face appear more symmetric at rest but does not restore muscle movement. 
• Dynamic Restoration: Enhances facial symmetry and restores movement, such as enabling smiling or eye closure. 

How Does Facial Reanimation Work?

Doctors use various surgical methods to address facial palsy, each tailored to the patient’s needs. 

• Nerve Repair: Involves directly fixing the damaged part of the facial nerve, though this is rare. 
• Nerve Grafting: Uses healthy nerve tissue from elsewhere in the body to connect nerve endings when extensive nerve damage occurs. 
• Nerve Transfer: Bypasses the injured nerve section entirely, utilizing a healthy donor nerve from another area of the face or body. 

Facial reanimation techniques are individualized and typically conducted in stages. Static options for the upper face focus on restoring symmetry at rest, while dynamic options aim to restore movement, such as smiling. 

Dynamic procedures may include nerve transfers, nerve grafts, muscle transfers, or repositioning tendons to enable facial movement. For instance, cross-face nerve grafts use redundant nerve branches from the healthy side of the face to restore symmetry in smiles without affecting the function of the unaffected side. Additionally, regional muscle transfers may be employed when nerve function cannot be restored, utilizing muscles like the temporalis or gracilis to enable facial movement. 

Surgery options for restoring movement in a paralyzed face depend on individual symptoms and needs. Techniques include microsurgical facial nerve repair, nerve grafting, nerve transfer surgery, muscle transfer surgery, muscle transplant (gracilis muscle facial reanimation), and procedures like facelifts and brow lifts to restore symmetry. Eyelid reanimation surgery can improve blinking and eyelid closure. 

For individuals with synkinesis experiencing muscle tightness or spasms, treatments may involve: 

• Botox injections (chemodenervation) to block nerve signals. 
• Physical therapy, including massaging, stretching, and neuromuscular retraining. 
• Selective neurectomy, cutting specific facial nerve branches to relax tight muscles and weaken opposing muscles. 
• Selective myectomy with terminal neurolysis, dividing facial muscles to address tightness and spasms. 

Am I a Candidate for Facial Reanimation?

Yes, if you have facial palsy. Diagnosis may involve electromyography (EMG), blood tests, and imaging to ascertain the cause and tailor treatment. Surgery considerations hinge on: 

• Personal objectives 
• Duration and extent of facial paralysis 
• Underlying cause 
• Remaining facial muscle function 
• Age and medical history 

Risks

Facial reanimation surgery carries risks, including temporary swelling, bruising, numbness, infection, changes in facial contour, nerve injury, and hematoma. Nerve transfer surgeries may carry a risk of incorrect nerve growth leading to synkinesis, while muscle transplant surgeries may risk poor movement due to lack of blood flow to the muscle, although these complications are rare. Improvement in facial paralysis may take months to become apparent, especially after nerve transfer or muscle transplant surgeries, as nerve cells need time to grow after being connected. Most people experience improvement after facial reanimation surgery, but complete restoration of function or perfect symmetry may not always occur. Additional procedures may be necessary to address complications or improve outcomes further. Facial reanimation surgery is personalized, and discussing risks and benefits with the surgeon and healthcare team beforehand is essential. 

What is Facial Synkinesis?

FAQs on Synkinesis: 

Are synkinesis symptoms consistent across all patients?

No, synkinesis symptoms vary among patients. 

Can facial nerve injury contribute to synkinesis symptoms?

Yes, synkinesis may be linked to damage in facial joints like the temporomandibular joint. 

Is synkinesis caused by stress and anxiety?

No, stress and anxiety do not directly cause synkinesis but can trigger involuntary facial muscle movements. 

How are facial synkinesis and Bell’s palsy related?

Bell’s palsy patients may develop synkinesis, although not always. 

Does Bell’s palsy always lead to synkinesis? 

No, but about 10% of Bell’s palsy patients may experience synkinesis. 

Are synkinesis treatments considered safe?

Yes, if performed by an experienced professional like Dr. Boonipat, synkinesis treatments are generally safe. 

When can patients expect to see results after a synkinesis procedure?

Results are typically visible shortly after treatment, but this varies based on individual factors. 

What is the typical recovery period for a synkinesis procedure?

Dr. Boonipat aims to minimize recovery time and provides detailed guidance for each patient. 

Do insurance providers cover facial paralysis synkinesis treatments?

Coverage varies among insurance providers, but our team assists in navigating insurance coverage. 

Are facial synkinesis exercises necessary for treating involuntary facial muscle movement?

Dr. Boonipat evaluates each patient to determine the necessity of facial synkinesis exercises. 

How are facial synkinesis exercises conducted?

Exercises are taught by occupational therapists or physical therapists and customized for each patient. 

What should I do if I experience pain during facial synkinesis exercises at home?

Patients should inform Dr. Boonipat, who can provide guidance or schedule a follow-up appointment. 

What is the most effective treatment for synkinesis?

A personalized treatment plan developed by Dr. Boonipat after evaluating the patient’s symptoms. 

How much does facial paralysis synkinesis treatment cost?

Treatment costs vary, and Dr. Boonipat discusses the pricing before proceeding. 

Can a virtual consultation be conducted for synkinesis treatment?

Yes, Dr. Boonipat offers both in-person and virtual consultations for synkinesis treatment. 

What is involved in a virtual synkinesis treatment consultation?

Dr. Boonipat reviews patient information, including photos, and discusses treatment options during the virtual consultation.