Post-facial paralysis sequelae generally refer to conditions where the disease course exceeds six months, either due to delayed treatment from improper methods or failure to recover despite multiple treatments. These sequelae consist of two parts: one involves residual symptoms from incomplete activation and functional recovery of the paralyzed nerve on the affected side; the other stems from irreversible damage caused by severe disease progression.Specific manifestations include: inability to raise the eyebrow or limited elevation, uneven eye size or drooping upper eyelid, mouth corner deviation when raising eyebrows, mouth corner pulling during eye closure, small eyes when puffing cheeks, shallow nasolabial folds, facial stiffness, difficulty swallowing, and tearing. So how can this be addressed? Let's hear from the experts.
Plastic Surgery Case:
I am 38 years old and unfortunately developed facial paralysis two years ago, which has not fully recovered. My current condition involves ptosis of the left eyelid and a narrowed palpebral fissure, causing asymmetry between my eyes. This makes me feel unable to hold my head high in front of others.Can cosmetic surgery resolve such post-facial paralysis complications?
Expert Response:
Peripheral facial paralysis falls into two categories: traumatic facial paralysis, caused by injuries or tumor removal;The other is Bell's palsy, which is quite common. It results from exposure to wind-cold or viral infections causing facial nerve edema, ischemia, and dysfunction. This leads to facial nerve paralysis, paralyzing the facial muscles controlled by the nerve. Symptoms include drooping of the affected side of the mouth, sagging of facial soft tissues, and inability to fully close the upper and lower eyelids, causing functional impairments and morphological abnormalities.You likely have Bell's palsy. Approximately 80% of Bell's palsy patients recover within two months through conservative treatment (medication, physical therapy), with full or partial restoration of facial expression muscle function. For the remaining 15%–20% of patients, facial nerve and expression muscle function cannot be restored. Like your condition, cases showing no improvement after two years are medically termed permanent facial paralysis.
Permanent facial paralysis can be addressed through reconstructive surgery for improvement. Numerous surgical approaches exist, broadly categorized into two types: dynamic repair and static repair. Static repair involves implanting autologous fascia or biomaterials into the face to suspend and tighten the lax orbicularis oculi and orbicularis oris muscles, restoring the position and shape of the eyelids and corners of the mouth.Dynamic repair involves transplanting autologous muscle and nerve grafts, or muscle grafts with intact blood vessels and nerves, to the paralyzed facial expression muscles. This restores facial expression function, enabling eyelid closure and coordinated, symmetrical movement of both corners of the mouth.
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