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Facial Paralysis

Facial paralysis is the inability to move one or more muscles in the face due to damage or swelling of the facial nerve, or brain damage in the area of the brain that controls the facial muscles.

This condition can cause a variety of issues that profoundly affect the way you function and interact with others, including the following:

  • Changes in your appearance, such as drooping on one or both sides of your face
  • Problems fully opening or closing your eyes; eye dryness or tearing
  • Inability to express emotion, especially smiling
  • Difficulty eating or drinking
  • Impaired speech
  • Muscle twitching
  • Ringing in one or both ears (tinnitus)

Bell's palsy, while rare, is the most common form of facial paralysis or weakness. It occurs when the facial nerve — which transmits signals from the brain to the muscles of the mouth, nose, eyelids and forehead — becomes swollen, inflamed or compressed.

Causes of facial paralysis

These are some reasons why you may experience facial paralysis or weakness:

Depending on the cause, the paralysis can occur suddenly. For instance, stroke and Bell's palsy will produce immediate weakness or paralysis. Paralysis resulting from tumors typically develops over time.

How can I get help for facial paralysis?

Call 911 right away if you experience sudden weakness or numbness in your face plus any of these symptoms:

  • Seizure
  • Severe, sudden headache
  • Blindness, even if it's temporary

If you don't have those specific symptoms but are concerned about weakness or numbness in your face, call your primary care doctor. He or she will ask you questions and, if necessary, order tests to figure out the cause.

Care for facial paralysis at Rush

Sometimes, facial paralysis goes away on its own. For example, newborns with childbirth-related paralysis almost always recover completely without any treatment.

If the paralysis does not get better, depending on the cause, your doctor may refer you for further treatment.

At Rush, you can receive coordinated, comprehensive care — testing, treatment, facial retraining, etc. — from plastic and reconstructive surgeons, neurotologists, neurologists, audiologists, speech-language pathologists, neurosurgeons, physical therapists and occupational therapists.

Depending on the cause and amount of paralysis, you may not need all of these specialists; like your treatment, your care team will be customized to meet your specific needs.

Nonsurgical treatment may include one or more of the following:

Surgical treatment. If you don't fully recover on your own or with nonsurgical treatment, surgery can often help restore facial symmetry and function — including your ability to smile and fully close your eyes.

At Rush, we tailor surgical treatment to each patient for optimal results. Your plan may include one or more of the following:

  • Facial reanimation surgery to help improve or bring back your smile:​
    • Nerve grafting, in which surgeons take nerves from another part of the body and surgically implants them in the face. This helps to restore both movement and sensation, so you can better control your facial muscles. Techniques include masseter-to-facial nerve transfer.
    • Muscle transfer, in which surgeons transplant or move muscles from another part of your body — usually leg, neck or jaw muscles. The newest type is gracilis smile restoration. Unlike other muscle transfer procedures that only enable a slight raising of the corners of the mouth, gracilis muscle transfer can restore a person's ability to smile. Rush was one of the first centers in the U.S. to offer gracilis smile restoration.
  • Other procedures to improve appearance and facial movement:
    • Blepharoplasty, or eyelid lift.
    • Eyelid weight surgery, in which surgeons place tiny implants in the upper eyelids to enable you to close your eyes completely.
    • Brow lift to keep your upper face symmetric, as well as prevent or correct difficulty with vision.
    • Static lift, similar to a face-lift, to restore symmetry to your face.
    • Synkinesis treatment, which involves selectively stopping muscles from twitching, or unwanted movements.
    • Platysmaplasty, to treat tight and painful contractures (abnormal shortening of the muscles that prevents normal movement) that sometimes occur in the neck.

Why choose Rush for facial paralysis care

  • Expertise you can trust: Plastic and reconstructive surgeons at Rush have extensive experience treating facial paralysis and will personalize a treatment plan for you.
  • Cutting-edge treatments: Rush offers a full range of surgical options, including gracilis smile restoration — a surgical procedure that can restore a person's ability to smile after facial paralysis. 
  • Highly ranked specialty programs: The neurology and neurosurgery program at Rush, which addresses some of the causes of facial paralysis, including stroke and brain tumor, is consistently ranked among the best in the country by U.S. News & World Report.

Departments and programs that treat this condition