Facial Paralysis

facialparalysislosangeles-Facial paralysis affects thousands of people around the world. Whether it occurs slowly over time or suddenly without warning, facial paralysis can be very scary for those encountering it for the first time.

Facial paralysis has many causes and can affect both children and adults. Regardless of the cause, our world-renowned multispecialty team of facial plastic surgeons, oculoplastic surgeons, neuro-otologists, and neuromuscular retraining experts will help you overcome this devastating issue.

The Director of our facial nerve team is facial plastic and reconstructive surgeon, Dr. Babak Azizzadeh. As a Harvard trained board certified facial plastic and reconstructive surgeon, Dr. Azizzadeh strives to always help those experiencing facial paralysis with a variety of surgeries and treatments. Dr. Azizzadeh has been extensively featured on Oprah Winfrey, People Magazine and Doctors Show for his cutting-edge facial reanimation procedures.

If you wish to schedule an appointment with Dr. Azizzadeh, contact La Peer Health Systems at (855) 360-9119.


A person experiences facial paralysis when they no longer have the ability to move one or several facial or eye muscles. Facial paralysiscan be both permanent and temporary, depending on the cause as well as the length of time that passed before it was brought to the attention of a medical professional.

To better understand what may be causing the facial or eyelid paralysis that you’re experiencing, please contact La Peer Health Systems today to schedule your consultation with world-renowned facial plastic surgeon Babak Azizzadeh, MD, FACS.

A common form of facial paralysis, which can be experienced by healthy people, is Bell’s palsy. Bell’s palsy occurs as a result of an inflamed facial nerve brought upon by a common virus that causes cold sores (Herpes Simplex Virus). Facial paralysis can occur as a result of other medical problems too, including but not limited to the following:

  • Acoustic neuroma
  • Facial trauma
  • Parotid tumors
  • Stroke
  • Intracranial vascular malformation
  • Intracranial tumors
  • Cosmetic surgery
  • Lyme Disease
  • Congenital
  • Mobius Syndrome


An emotional spontaneous smile is the ultimate goal of any patient suffering from facial paralysis. There are only a few operations that can truly achieve this outcome. The cross facial nerve graft, when combined with gracilis muscle flap, is the gold standard for patient with long-standing facial paralysis.

In short, a cross facial nerve graft aims to allow a patient to regain facial movement on the paralyzed side of their face by manipulating the facial nerve of the working side of the face through a surgical nerve transplant. Undergoing a facial nerve graft requires a great deal of time and patience from anyone suffering from facial paralysis, as it can take up to and exceeding a year to complete.

During this type of procedure, a facial paralysis surgeon harvests a nerve (the sural nerve) from the patient, usually from the lower leg. This nerve is then attached to the patient’s normal facial nerve on the opposite side of the paralysis, which still has movement. In the next part of the procedure, the gracilis muscle is harvested from the inner thigh and attached to the nerve graft as well as an artery and vein in the neck. This allows the paralyzed side of the face to spontaneously and emotionally move when the patient smiles or speaks.

When a patient chooses to undergo this type of surgery, physical therapy is generally needed for up to 18 months. Throughout the first several months after the second stage of the surgery, patients will gradually begin to see an increase in facial movement on the paralyzed side of the face. This will continue to improve for the next couple of years. Dr. Azizzadeh has written several textbooks on facial plastic and reconstructive surgery, including one dedicated entirely to facial paralysis procedures.


A static sling can help treat a variety of ailments that accompany facial paralysis. These include the following:

  • Re-position drooping mouth and face
  • Fix facial symmetry
  • Regaining control over inner gum biting and drooling
  • Re-create a laugh line

During this procedure, a structure similar to that of a tendon is taken from the thighs to aid in the creation of a laugh line. To perform the procedure, an experienced facial paralysis surgeon will make an incision in front of the ear that heals extremely well. Then, the tendon is properly placed underneath the skin and will not be visible at all. Some patients may elect to undergo facelift procedure to further create symmetry and improve differential aging process.

Following this type of procedure, the patient usually sees a significant improvement in facial symmetry, as well as symmetry of the lips and mouth.


Unfortunately, the facial nerve may be severed due to trauma, tumor, or surgery. Facial nerve repair may be performed if the two ends can be identified. When the nerve cannot be reattached, your surgeon may perform a nerve graft, in which a nerve is harvested from a different area of the patient’s body and reconnected to the severed facial nerve.

Following nerve repair, the recovery process can be slow and requires patience, though it can be different for every patient.


The temporalis tendon transfer is one of the most common ways to improve facial symmetry and allow dynamic restoration of the smile. This procedure is an excellent one-stage option that can improve symmetry, reduce functional deficits associated with facial paralysis, and provide dynamic smile mechanism. The procedure is typically performed as an outpatient same day surgery and patients with complete facial paralysis are candidates.

The procedure is performed by taking advantage of the muscles that allow us to chew. The temporalis muscle’s tendon is attached to the corner of the mouth through limited incisions restoring symmetry and function.

Physical therapy is required to help patients learn to smile in a new way.


The trigeminal-facial nerve transfer, popularized by Dr. Babak Azizzadeh, is one of the most effective ways of restoring a natural smile in patients who have had facial paralysis of less than three-year duration as a result of trauma, tumor, vascular malformation, and acoustic neuromas. The masseteric nerve (branch of the trigeminal nerve) is attached to the patient’s facial nerve, allowing the patient to smile in the most natural way available. The smiles from this operation far surpass any other facial reanimation technique and often times can be combined with cross facial nerve grafts to even get better outcomes.


In certain cases of facial paralysis and Bell’s palsy, the use of Botox has become extremely prevalent and useful in the condition’s treatment. Botox can also be very helpful in treating synkinesis, or the involuntary movement of facial muscles, much like a twitch or contraction that can last for quite some time.

Botox works to relax muscles experiencing synkinesis in the face, which improves facial symmetry. Because Botox works to paralyze muscles, injecting the substance into a person experiencing facial paralysis actually helps bring balance to the facial features by lessening the drooping downward pull. To find out if you might be a good candidate to undergo Botox treatments to help overcome your facial paralysis or Bell’s palsy, please contact La Peer Health Systems today.


Sometimes, facial paralysis can result in a lowered appearance of the eyebrows. This is caused by a weakness in the muscle that holds the brow in place. A relatively easy and simple treatment option to assist a patient in the recovery process is to undergo a brow lift.

Most commonly, a mid-forehead brow lift is performed. Depending on the circumstances surrounding certain cases, a less invasive endoscopic brow lift might also be performed.


An effective procedure, known as the upper eyelid gold weight, is performed to treat cases of eyelid paralysis. Normally this procedure is done by an oculoplastic surgery team at Lapeer Health Systems made up of some of the top experts in the field of eyelid reanimation. During surgery, your surgeon will place a small gold plate in the upper eyelid to increase its weight. This weight allows the patient the ability to close their eyes and blink much easier than before.

Hyaluronic gel injections, including Juvederm and Restylane, can also be used to treat eyelid paralysis. During this procedure, your surgeon will inject the gel into the upper eyelid to increase its weight. This also assists the patient when closing the eyes and blinking.

After visiting with one of La Peer’s facial nerve experts, you’ll have a much better idea of what is necessary to treat your unique facial paralysis or eyelid paralysis case. To determine if you’re a good candidate for upper eyelid gold weight surgery or hyaluronic acid treatment, contact our staff of board-certified surgeons. Our doctors use the best and most effective techniques for the treatment of facial paralysis.


Are you experiencing facial or eyelid paralysis? Would you like to find out how our facial plastic and reconstructive surgeons in Los Angeles can help? Then contact La Peer Health Systems today to better understand which treatment options may be best for you.

La Peer Health Systems is home to world-renowned facial paralysis surgeons. Our doctors have helped hundreds of patients overcome their facial paralysis. Dr. Babak Azizzadeh is a renowned authority in the medical field, and he’s even written a textbook on the facial nerve.

Our facial plastic surgeons understand that each patient is unique, and we aim to provide a tailored treatment plan to help those experiencing facial paralysis feel much more comfortable about their surgery. Please visit our contact page or call (855) 360-9119 to schedule your initial consultation in Beverly Hills.

Next, read about Grave’s Disease.