Two Surgical Options for Facial Paralysis | Johns Hopkins Facial Plastic and Reconstructive Surgery

Two Surgical Options for Facial Paralysis | Johns Hopkins Facial Plastic and Reconstructive Surgery

[MUSIC] The thing with facial paralysis
is tough, especially in my profession, working with
students or younger children. They’re very curious
about what happens. At the beginning of the year you kind of get them talking
behind my back a little.>>Everything on this side
of my face no longer worked. Because the effect on
the muscles it was very noticeably droopy. People looked at me and
thought I had a stroke.>>So
facial reanimation refers to the treatment of
facial paralysis. So these patients have
the inability to move one side of their face. So by facial reanimation we
restore their ability to smile, to blink, to show emotion, to allow them to integrate
into society better. Patients with facial paralysis
of long-standing duration really have two options to restore
their ability to smile. [MUSIC] In the first,
we use a muscle in the face, the temporalis muscle,
and we reroute it. And this allows them
to smile by clenching. We refer to that as
the temporalis tendon transfer. It’s a procedure that
we’ve helped popularize in North America.>>Right afterward
it was very drastic. With the muscle being
pulled up so far. It took awhile for
my face to relax.>>The temporal’s tendon
transfer, the T3, is a very quick one
hour procedure and that can be performed
as an outpatient. It’s pretty simple to perform. It very predictably elevates
the corner of the mouth, and it can restore a smile
in a majority of people. And so a lot of patients
like that procedure because it’s pretty quick and it’s
pretty simple to go through. The only real downside to it
is that the amount of smile that it can produce tends to be
smaller than the second option.>>During the recovery process
I actually was seeing, I think she was
a physical therapist, where I would go
a couple times a month. And we would work on
doing facial movements. So it would be things such
as raising my eyebrows, trying to pucker my lips,
sucking out of straws. Different activities to get
parts of my face moving. But when I learned about this
surgery, and the idea of being able to create a smile again,
it was almost like a no brainer. [MUSIC]>>The second option for
patients with long standing facial paralysis is something
called a gracilis free tissue transfer or
a gracilis free flap.>>He explained the procedure
to me, removing this kind of disposable muscle on
the inside of your leg or just kind of giving it a new
job, putting it in your mouth. I thought that was about
the coolest thing I’d ever heard in my whole life, and
I made him tell it to me again.>>That’s a more
complicated procedure. It’s something that’s very safe,
we do it all the time here. But it involves a hospital
stay of a few days. It takes several months for
the muscle to start working.>>It was a process. And when I got through
with the flap insert, that all had to heal, so
I was still on a straw. I couldn’t measure anything. I couldn’t really open my
mouth to brush my teeth. And little by little,
and I mean, little by little that changed
and became very evident. So that pretty soon I’m
brushing my teeth like, it’s like this part of my
mouth is cooperating more.>>The greatest
advantage of it is that the smile that the gracilis can
produce is really profound. It tends to be a big
beautiful smile. Our group at Hopkins is very
unique in the United States at. One is simply that we perform so
much facial reanimation surgery. And we just have
a lot of patients and a lot of experience
in facial paralysis. But one thing
that’s also unique, is that we have such a robust
cosmetic surgery practice. So each of us routinely performs
elective cosmetic surgery only of the face,
as well as micro-surgical facial reconstruction,
including facial paralysis. And it’s our belief that these
two sets of skills really are crucial, really crucial to
a patient with facial paralysis. Because what we’ve found
over time is that facial paralysis patients,
they want to look their best, they want to integrate into
society and feel confident. And it’s been my experience that
not only restoring the smile and the movement, but also
optimizing the facial appearance is incredibly powerful for
these patients. It really helps improve
their quality of life.>>It’s been seven years since
my surgery now and the one thing people are always telling me
is you have a great smile, so it makes it all worth it.>>I can smile. And I have so
many reasons to smile that have to do with
the outcome of that implant. I can look at myself
in the mirror now. [MUSIC]


  • Kaef Cast says:

    any one try surgical option for bell's palsy? احد قد جرب الجراحة لعلاج الوجه ؟

  • Tessa Jackson says:

    Please help me. I've tried to contact you personally but I live in Australia and the Hopkins website only allows me to make direct appointments in America. I was born with Bells palsy and at age 4 my surgeon did a WORLD FIRST in grafting my thigh muscle into my cheek. Though I now have some function I am so desperate for you to please contact me. I can't keep living with this massive facial abnormality. I feel so alone and strange, there is no one online that has the same situation I do that can compare results. I will pay anything, do anything to make my face more symmetrical. Please help me.

  • E.C. MItchell says:

    I suffered a bells palsy paralysis in 1991 and I was offered no hope at that time after watching this video I see there is a way to help me. can you please give me some direction on who might do this procedure in las vegas? thank you. I just want my smile back.

  • Maria says:

    I had bells palsy when i was 14 years old, and im 65 now, my question is, does that effect your eyes, because i can't see to well out of my left eye, it's the center of it that im blind but i can see on the outer of the same eye. Thank You!
    Galveston county, Texas

  • Netzna phan says:

    I got bells for 14 years. My bells is very light. I just want my dimple back

  • johns smith says:

    A doctor cutted my facia nerve in 1984 while removing a cyst I was 1 month old, now I am 34 can surgery help me out and which surgery ??

  • jay dubh says:

    i got bell palsy twice when i was 13 and in my early 20s im mid 30s now and ever since every time i eat 1 eye waters and my nose runs on one side i looked into it and found out about synkinesis so i mentioned to my doctor today and he says its a difficult fix and left it at that is it something i will suffer with all my life it doesnt seem like im gonna get any treatment for it sad face 8o(

  • Charles Moore says:

    Anyone know the cost of the two options ? I am guessing health insurance typically would not cover this ? Thx

  • Amber Bolli says:

    I've had a nerve transplant from my left lower leg, and muscle transplant from my right thigh. I was born paralyzed due to some birth trauma during my development. I feel like my surgery left me with a huge lump in my face, is the 2nd option the same option I've already had done, if so, how are these people's faces so symmetrical?

  • Vanilson Bretas says:

    Maravilhoso!!! Parabéns pelo trabalho!!! Vou me submeter a esta cirurgia aqui no Brasil em breve!!! Abraços! Thank you!

  • Breana Tangelino says:

    Dr. Byrnes assistant was exceptionally rude to me and I came from across the country!! Also, be aware that only the best outcomes were shown here but if you ask, you can see MANY not so ideal examples. Some people looked the same before and after and in a few cases, worse.

  • eliodysseys says:

    I was born with facial paralysis. At age 10 (1992), Dr. Wilkins, through Mott Children's Hospital in Ann Arbor, Michigan, performed the tissue transfer. I am finding, as I age, my palsy side is aging faster and I'm losing sensitivity on the inside of my mouth. I'm wondering if now there are "follow-up" procedures available to help restore sensitivity and correct my droopy eyelid.

  • Sunny says:

    HI, just want to know what is considered long standing paralysis. I have had bell palsy for right at 3 months with no movement. I'm losing hope that my face will get better.

  • yahya aljezani says:

    I have damage nerve like her
    Can someone inform me by phone number or address and any doctor name please

  • NATIAN Patricia says:

    Hi all i suffered from bells palsy 4 years now and recovered 50 % only and 2 days ago the docteur proposed me for a surgery and i was shocked caused i ve never heard about it ….. can a professional or someone who did it already help me for more info …… how much time for recovery does it have negative effect ?? does ithave a risk ? and what kind of risk ? Iam really stressed . Thanks you very much

  • M N says:

    Can this procedure be done in babies??

  • Kristine Bayaborda says:

    Help me

  • Rajesh Debnath says:

    Still Iam Suffering

  • Diana Asturias says:

    How much does the surgery cost? Aprox.

  • singing fan's 1 says:

    Plzz… Help me.. I'm petient of the facial paralysis 2 year old.. Of right and left side. But my facial paralysis recovered of 75%. And now my face not a movement of lips and nose muscles.. So plzzzzz…help me.. My contact no.
    8958814657, 8192954260 this is my call and what's app no. Plzzzzzz help me… Plzzz.. My requested to all of you…

  • queen chadonnay says:

    My mom was a cancer patient wen i was hit by bells palsy .6 yrs ago. The dr told me to bite on a pencil constantly to strengthen my muscles by the mouth and it worked .

  • Hina Hassan says:

    I am in Pakistan …. Plzz help me to

  • Gugu Gill says:

    My face jammed all of a sudden on the right side and I knew Bell's Palsy has struck me. I couldn't move a muscle, nor blink my right eye, could not even speak with proper pronunciation. I reached Planet Ayurveda and got Bell's Palsy Care Pack and some diet tips that I followed sincerely. It made me recover the original posture within 2 months.

  • للب ةبيص says:

    Please help me I from saudi Arabia

  • Sheryl Ann Malaza says:

    I have a bells pulsy since im 2 years, now im 35 years old.i hope someday i can laugh freely, in God's willing

  • Megan says:

    Thank you so much for making this video… so helpful you have no idea

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