Restoring facial harmony after facial palsy

Introduction to smile surgery for facial weakness:

Smile surgery for facial weakness typically refers to a set of procedures aimed at restoring or improving the ability to smile in individuals with facial paralysis or facial weakness. These procedures are part of facial reanimation techniques and are designed to address the loss of facial muscle movement and symmetry.

A number of different options are available:

1. Nerve repair. If caught early enough, an injured facial nerve can be repaired. This allows the electrical cables that form the nerve to re-grow and eventually stimulate the facial muscles again.
2. Nerve transfer. In certain cases where the muscles of the face remain healthy, but dont have any stimulation from the facial nerve, a nerve transfer procedure can be considered. This involves taking all or part of a nerve that either controls a chewing muscle (masseteric nerve), tongue (hypoglossal nerve), or extending a nerve from the healthy side of the face (cross facial nerve graft). The nerve being donated is then connected to the paralysed muscles to help encourage facial movements.
3. Supportive slings. In patients keen to avoid, or not suitable for, prolonged operations, a supportive sling can be placed underneath the skin to help support the corner of the mouth. This helps centralise the lips on the face and can reduce the amount of drooling and make eating and speech easier. Usually the tissue needed to form the sling is taken from the thigh.
4. Muscle transfer. In a muscle transfer operation, a muscle is taken from elsewhere on the body and used to generate a smile. This is typically reserved for cases where the natural muscles in the face can not be made to move anymore. The muscle can either be taken from the temple (lengthening temporalis myoplasty) or from elsewhere on the body (free functional muscle transfer)

At your consultation, Mr Butler will undertake a detailed assessment of your medical history and current facial movements to help determine the treatment options available to you.

Key details of the procedure:

• Duration: 2 to 8hours
• Cost: $20000 to $90000‍
• Anaesthetic: General anaesthetic‍
• Length of stay: 1-4 nights in hospital

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