This page explains what can be done when one side of the face does not move. It covers eye protection, nerve and muscle surgery, and how the plan changes with the length of the palsy.
Facial nerve paralysis treatment depends on how long the face has been weak. Early on, the aim is to protect the eye and support the nerve while it tries to recover. When the palsy is old, a nerve transfer or a muscle transfer may be used to bring movement back. Every plan starts with a careful assessment.
The facial nerve carries signals that let you blink, smile and keep food inside your mouth. When it stops working on one side, the eyebrow drops, the eye may not close and the corner of the mouth sags. Speech and eating can feel awkward, and many people notice the change most when they laugh or talk.
Timing shapes the whole plan. During the early months the nerve and the facial muscles may still be alive, so the aim is to protect the eye, keep the muscles healthy and repair or graft the nerve where that is possible. After a long period without signals, those muscles waste away and cannot be woken up. A working muscle is then brought in from elsewhere, along with a nerve supply to drive it.
Assessment includes examining every zone of the face, checking eye closure and tear production, and reviewing any scans or nerve studies you already have. From this a staged plan is written out, so you know which problem is being treated first and what the next step may be.
Before anything else, the eye is made safe. Lubricants, taping at night and small eyelid procedures such as a weight in the upper lid or tightening of the lower lid help the eye stay covered and comfortable.
Your surgeon maps which parts of the face still move, how long the weakness has lasted and what caused it. Nerve studies and imaging may be added so the plan matches the real state of the nerve.
If the facial muscles are still healthy, a damaged nerve may be repaired, bridged with a nerve graft, or driven by a nearby nerve borrowed from the chewing muscle or the other side of the face.
When the facial muscles have wasted, a slim muscle is moved from the thigh or nearby chewing muscle and connected to blood vessels and a nerve, so it can pull the corner of the mouth upward.
Later touches even out the two sides. These can include small adjustments to the brow, the lower eyelid, the lip or the neck, along with therapy to teach the new movement.
Swelling and bruising are at their peak and the face may look fuller than expected. Eye care carries on exactly as advised. Pain is usually managed with simple medicines.
Stitches and dressings are reviewed. Swelling settles slowly, and gentle facial therapy often begins so the muscles and skin stay supple.
Most people are back at work and normal meals. After a muscle transfer there may still be no visible movement, which is expected at this stage.
New movement often appears gradually and then grows stronger with practice. Reviews continue, and small refinements may be discussed once the result has settled.
Facial reanimation can improve movement and comfort, but it does not restore a face to exactly how it was. Both sides of that picture are explained before you decide.
Cost depends on which stage you need, how long the operation takes and whether microsurgery is involved. A single eyelid procedure sits at one end of the range and a free muscle transfer with vessel and nerve joining sits at the other. Hospital charges, anaesthesia, implants such as an eyelid weight, therapy sessions and review visits all add to the total. After your assessment you are given a written estimate that lists what is included, so there is no guesswork later.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →There is no single price, because the plan differs for every face. An eyelid procedure costs far less than a muscle transfer with microsurgery. Once you have been examined, a written estimate covering surgery, hospital charges, anaesthesia and reviews is given to you.
Every operation carries some risk, and yours is judged on your health, your age and the procedure planned. Blood tests and a fitness check are done first. Bleeding, infection and slow healing are the usual concerns, and steps are taken to keep them low.
Swelling settles over the first few weeks and most people return to routine work well before movement appears. After a muscle transfer, the first flickers often take several months, then build slowly with therapy. Recovery speed varies quite a lot between people.
The aim is a face that rests evenly and moves more naturally when you smile. Blink and fine expression are harder to restore. Improvement is realistic, but an exact match with the healthy side is not something any surgeon can promise.
Yes, in many cases. Old weakness usually means the original facial muscles no longer work, so a new muscle is brought in instead. Suitability is decided after examining your face, your general health and what you most want to regain.
Timing matters a great deal. Early review protects the eye and keeps more options open, since a repairable nerve may still be repairable. Later treatment is still worthwhile, though the approach shifts towards bringing in new muscle and nerve supply.
Your history is taken, then each part of the face is examined for movement, eye closure and tone. Photographs and video may be recorded. The likely stages, risks and recovery are explained, and you leave with a written plan and estimate.
Each technique below has its own page explaining how it works and when it is chosen.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
