Facial Paralysis

Facial paralysis, or loss of movement in the face, is a result of nerve damage. The muscles in the face may become weak and appear to droop on one or both sides of the face. Facial paralysis can be caused by stroke, trauma, tumors or infection.

Our Capabilities

At UC Health, we offer unique and leading-edge treatment opportunities for facial nerve disorders available at few institutions worldwide. Our facial plastic and reconstructive surgeons take exceptional interest in this condition and are national experts in the field, publishing research, discovering new surgical procedures and lecturing at national conferences on facial paralysis topics.

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Our Facial Plastic & Reconstructive Surgery subspecialists are double-board certified as head and neck surgeons, delivering patients the skills required for superior results in both cosmetic and functional procedures. Our physicians are national leaders in the most complex and innovative facial reconstruction techniques needed for traumatic injuries, cancer and other conditions.

To schedule an appointment, please call the UC Health Facial Plastic & Reconstructive Surgery team at 513-475-8444.


Understanding Facial Paralysis

What is facial paralysis?

In addition to allowing us to smile, grimace, or frown, our facial muscles are needed to protect the eye, maintain an open nasal airway, and keep saliva in our mouth. Losing the function of these vital muscles leaves us with a facial droop devoid of expression, often with embarrassing issues with drooling and tearing. It is no surprise that the diagnosis of facial paralysis can be devastating and socially isolating to the patient affected.

What causes facial paralysis?

Facial paralysis may be congenital in nature, related to trauma or tumors in the salivary glands or skull base. It can also be caused by conditions such as bell’s palsy or a stroke. 

Bell’s Palsy

Bell’s palsy is the most common cause of paralysis in the face. It begins suddenly and can worsen over 48 hours. This condition results from damage or inflammation to the facial nerve which can cause one side of the face to droop.

Bell’s palsy can strike anyone at any age. It occurs most often in pregnant women, and people who have diabetes, influenza, a cold, or another upper respiratory ailments. 

Bell's palsy is not considered permanent. But in rare cases, it does not disappear. Currently, there is no known cure for Bell's palsy. Recovery, though, usually begins 2 weeks to 6 months from the onset of the symptoms. Most people with Bell's palsy recover full facial strength and expression.


A stroke is a sudden loss of brain function caused by a lack of blood flow and oxygen. A stroke can cause facial drooping when nerves that control the muscles in the face become damaged. Most commonly, the lower part of one side of the face is affected. The corner of the mouth can become weak, resulting in drooling. Difficulty speaking may also occur.

What are the treatment options for facial paralysis?

Treatment options are based upon the specific nature of a patient’s paralysis and may include both non-surgical and surgical strategies. Non-surgical options include specially designed physical therapy as well as Botox or Dysport treatments. Surgical options range from rerouting functional nerves to the paralyzed facial muscles, sling procedures, or muscle transfer or transplant procedures. Additionally, brow-lifting, eyelid lifts, and even facelift-like procedures can improve facial symmetry.

  • Selective Neurectomy. The selective removal of facial nerves to improve balance and smile in patients with hyperactive facial movement (synkinesis) after previous Bell's Palsy or brain surgery.

  • Masseteric Nerve Transfers. Rerouting intact chewing nerves into facial muscles to create smile in the paralyzed face.

  • Hypoglossal Nerve Transfers. Rerouting intact tongue nerves into facial muscles to create smile in the paralyzed face.

  • Cross Facial Nerve Grafting. Routing facial nerves on the unaffected side of the face to the paralyzed face to reestablish spontaneous movement.

  • Gracilis Free Flap. Transplanting a slender muscle from the upper leg into the face to create movement in the chronically paralyzed face.

  • Temporalis Tendon Transfer. Transposing the tendon of the chewing muscle to the corner of the paralyzed mouth to establish new smile in the paralyzed face.

  • Oculoplastic Surgery. A series of procedures that protect the paralyzed eye from exposure related pain and damage.

  • Selective Chemodenervation. The use of Botox® to improve facial balance in hyperactive facial nerve disorders (synkinesis) after previous Bell's Palsy or brain surgery.

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