A facelift is a complex surgery mainly utilized for boosting the facial soft tissues on the patient’s face that has experienced facial paralysis. Facial paralysis can be permanent or temporary. The lower eyelid and below the jawline area are usually addressed in this surgery.
Facelift surgery is often achieved after a highly successful operation, or it may require stage-by-stage procedures. Using microsurgical techniques recommended by the reputed clinics such as Facial Paralysis Institute, the excess skin is removed, and muscle layers are tightened to decrease the facial droop seen at the corner of the lip, nose, jawline, and upper neck.
However, the real challenge comes when performing this surgery and achieving the best result for the patient. The surgery’s outcome can vary depending upon the surgeon’s experience. A surgeon often combines neck lift to reduce sagging skin on the neck and fat deposits as a part of a facelift.
What Are The Most Common Symptoms?
- Difficulty closing the eyelids
- Less tear production
- Inability to smile, frown or make any other facial expressions
- Paralysis on one side of the face
- Dropping near to one side of the mouth
- Loss of taste
- Sound sensitivity
How Is Facelift Surgery Performed For Facial Paralysis?
For some special patients, medical treatment and therapy may not work, and surgical treatment is needed. Surgical procedure is often performed stage by stage and categorized by the type of reconstruction to better optimize facial functions and symmetry. It can be either static or dynamic.
Static and Dynamic Surgery Procedures
Some patients face difficulty while controlling their mouth and cannot smile. Moreover, they also face issues while eating the food. Intervention that does not create movement in eye muscles prompts less eyelid tone, which causes droopiness in the eyelid’s lower area and increases dryness. The dryness can be debilitating and adversely affect the vision. These reconstructions are the best treatment option.
Static procedure refers to the facial slings that don’t produce any movement. This surgery is performed on the mouth’s corners and the eyelid’s lower area to improve symmetry and function. In contrast, dynamic procedures are generally performed to restore all the dynamic functions to the face. Patients can see the resting tone of their face and mouth and re-create a beautiful smile.
For superior results, dynamic facial reconstruction is highly suggested for children. However, for some parts of the face or types of paralysis, dynamic reconstruction is challenging, and Facial Paralysis Institute’s surgeons recommend static reconstruction.
The 2-Stage Traditional Approach
The traditional 2-stage approach involves performing two surgeries in a one-year gap. The initial surgery is usually performed to position the cross-face nerve and reconnecting them with micro sutures quickly. Reconnecting the nerve branches helps in identifying the particular function of all five branches.
Sometimes, the end of nerves does not reach one another and needs a nerve graft to bridge the gap from one end to the other nerve end. Thus, one branch would be relinquished and attached to the nerve graft. However, it won’t affect the normal side as they have different cross paths. The nerve graft will be tunneled via the facial tissues and pulled out from the paralyzed side.
The result of the graft is not seen as it will be placed for nearly one year while it repairs itself. A cable is also attached to provide an analogy and directed to the paralyzed site. After a year, it gets ready to get the motor or muscle. For the second part of the surgery, a gracilis muscle is attached to the facial nerve graft.
The transplant is done by connecting the blood vessels with the never via the microsurgical procedure. After 8-12 months, the muscle is reinvented, and motion is gained.
The 1-Stage Technique – Newer Surgery
A newer surgery is performed on a single stage for muscles. A similar muscle, gracilis, is used for the transplant and attached to the masseter in this surgery. The masseter muscle controls jaw movements. This procedure is similar to taking a table lamp with a power cord injured and placing a cable plugged with a different outlet for the power supply.
It is a highly recommended procedure and is possible only after the paralysis has occurred. If you waste more time, the connection between the muscle and nerve replaces scar tissues and cannot function well with a different power source.
Advantages of Newer Technique
- 1-stage reconstruction rather than 2
- Quick reinnervation
- High reproducibility and consistency
- Create a more balanced smile with a stronger excursion
The masseter technique gradually improves the smiling. Once chewing/eating movements are mimicked, the transferred muscle will start working. However, with some therapy and valuable tips, patients can learn to activate the muscle.
They can also train the muscle to function adequately and achieve symmetric smiles. The procedure takes a couple of months, so be patients.
Reach out to the experienced surgeon from the Facial Paralysis Institute, who can give you more information about both the surgical procedures and tailor the reconstruction plan as per your particular goals and the level of facial paralysis.