Facial reanimation surgery

Facial reanimation surgery helps restore movement and balance to the face after facial paralysis. When the facial nerves are damaged, the result can be weakness or loss of movement, usually on one side of the face. This can make it difficult to smile, blink, or fully close the eyes or mouth. These changes may also affect speech, eating, eye health, and self-confidence. Facial reanimation surgery can improve both function and appearance, helping you express yourself more naturally again.

These procedures require a team with advanced training in restoring facial movement. At Penn Medicine, surgeons with expertise in microsurgery, reconstructive surgery, and facial plastic surgery perform these procedures. We’re one of the only health systems in the region offering this level of care.

You may be a candidate for facial reanimation surgery if you have facial paralysis, facial weakness, facial asymmetry, or a facial nerve disorder. These problems may develop after:

• Bell’s palsy
• Ramsay Hunt syndrome
• Lyme disease
• Stroke
• Nerve tumors
• Head and neck cancer
• Facial trauma
• Autoimmune disease

In general, surgery can be most effective when performed within the first year after nerve injury for maximum facial muscle viability. Acting early can also protect the eye if paralysis makes it difficult to close the eyelid.

Even if more than a year has passed, you still have treatment options. Procedures like muscle transfer, implants, or office-based treatments can help restore movement and expression. Seeing a facial reanimation specialist as soon as possible allows you to understand all the approaches available to improve function.

Facial reanimation surgery is highly personalized. Your care team will walk you through the process, explain your options, and answer your questions so you feel prepared. Depending on your needs, some procedures can be done right in the office, while others take place in a hospital or surgery center.

Office procedures are simple and don’t require fasting, an intravenous line (IV), or general anesthesia. You’ll get numbing medicine, like what you’d receive at the dentist, so you stay awake but comfortable. These visits are usually quick, and you can go home the same day. For more complex procedures, surgery is done in the operating room under anesthesia. Your surgeon makes small incisions to access the nerves, while your care team stays with you throughout the procedure to keep you safe and comfortable.

Recovery looks different depending on whether your procedure is done in the office or in the operating room. Office procedures usually have a quick recovery. You may have some swelling for a few days, but most people are back to their usual activities right away. Because there’s no general anesthesia, you can often drive yourself home and return to your routine without major restrictions.

Recovery after surgery in the operating room takes longer. You’ll go home within a day or two, but your body needs more time to heal. Some swelling and discomfort are expected, and your care team will give you medication to help manage it. While physical healing happens in the first few weeks, it can take six to 12 months before you notice improvements in movement as the nerves slowly recover and grow. During this time, your surgeon will work closely with physical therapists, who guide you through exercises that help train the new nerve to create facial movements like smiling.

All procedures carry some risks. With facial reanimation surgery, possible risks include pain, bleeding, infection, scarring, or the need for another surgery later. These are similar to the risks that come with most types of surgery.

Your care team will talk with you about these risks before your procedure and explain what steps they’ll take to reduce them. Facial paralysis often requires long-term care, and your surgeon will continue to work with you over time to help you get the best possible outcome.

A systematic approach to facial reconstruction

Facial reanimation surgery isn’t a single procedure. It’s a highly tailored process that may involve several treatments over time. That’s why Penn Medicine’s specialists build long-term relationships with each person, serving as a partner in recovery.

We offer:

• Specialized expertise: Our surgeons focus on facial plastic surgery and reconstructive surgery. They have unique experience in treating facial paralysis.
• Collaborative care: You’ll see both your surgeon and a physical therapist who specializes in neurologic disorders and facial paralysis, giving you a true team approach.
• Advanced science: As part of a premier academic medical center, we’re involved in research and clinical trials aimed at improving outcomes and expanding options for facial reanimation.
• Regional leadership: Penn Medicine is one of the only health systems in the region to offer these procedures.
• Education and support: The Center for Human Appearance at Penn Medicine addresses the physical, emotional, and social aspects of facial differences and supports research to improve quality of life.