Facial Paralysis & Bell’s Palsy

Facial Paralysis, also known as Bell’s Palsy, can be caused by many different reasons. Some people are born with one or both sides of the face not working, either because of trauma during delivery or because of a rare conditions such as Mobius Syndrome, Melkersson-Rosenthal Syndrome, and hemifacial microsomia. Facial paralysis can also be caused by an infection, or trauma to the face or a fracture to the temporal bone (the skull bone behind the ear). Finally, tumors in the parotid gland, middle ear and cerebellopontine angle can compress the nerve and cause it to not function.

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Causes of Facial Paralysis
Facial Paralysis Treatment
Benefits of Facial Paralysis Treatment
FAQs About Facial Paralysis (Bell’s Palsy)

Causes of Facial Paralysis

Facial Paralysis can have many different causes. Bell’s palsy is the most common cause, and is a condition that results from nerve damage to the facial nerve and causes weakness or paralysis of the facial muscles.¹ Typically affecting only one side of the face, and in rare cases both, symptoms of Bell’s palsy can range from mild weakness in the facial muscles to complete facial paralysis. This condition can make normal facial expressions, such as smiling or closing the eyes, difficult. While the cause of Bell’s palsy isn’t understood, it’s thought that a viral infection in the facial nerve—such as Herpes Simplex virus, responsible for cold sores, Epstein-Barr, or Lyme disease—causes swelling and inflammation in the facial nerve and this causes the nerve to not function properly. While Bell’s palsy affects men and women of all ages, it is more common between the ages of 15 and 60.²

Other causes of partial or total facial paralysis can include sarcoidosis, facial nerve palsy, trauma, infections such as mononucleosis, tumors, and Lyme disease. All conditions that lead to facial paralysis can cause one or both sides of the face to droop, the inability to close one or both eyes, dry eye, drooling, headache, tearing, loss of the sense of taste, tinnitus (ringing in the ears) and pain.

Benefits of Facial Paralysis Treatment

The procedure can provide:

Improved facial appearance
Restored facial function
More confidence and sense of self

Facial Paralysis Treatment in Houston

For patients who know the cause of their facial paralysis and have facial asymmetry, there are several reconstructive surgeries that can be done to improve the appearance and function of the face. The options vary depending on how long the paralysis has been present, the severity of the asymmetry, age of the patient, and what the patient wants. There are many options ranging from short procedures that can be done in the office to long surgeries that are done in two stages with months in between.

Our surgeons specialize in cosmetic and reconstructive face and neck surgery and are dedicated to restoring facial function for patients with facial paralysis and muscle weakness. We offer a variety of treatment options and tailor custom treatment plans that take into account your medical history, your desired facial movements, and your cosmetic goals.

Treatment of Bell’s Palsy and facial paralysis may include:

Eye Closure Treatment

Eyelid Weight: A metal eyelid weight can be placed beneath the skin of the upper eyelid to facilitate proper closure
Lateral Tarsal Strip: A procedure that increases horizontal eyelid tension and tightens a drooping lower eyelid

Brow Asymmetry Correction

Brow Lift: Raises one eyebrow on the affected side to match the normal side
Non-Surgical Brow Lift: Raises one eyebrow on the affected side to match the normal side

Facial Drooping, Twisting, & Contracting Treatment

Botox^®: A neurotoxin can be injected into areas affected by paralysis to correct a contracted or twisted appearance

Smile Restoration

Cranial Nerve V to VII: A procedure where the masseter nerve is connected to the facial nerve
Cross Face Nerve Graft: A procedure that extends the working facial nerve on the unaffected side using a nerve graft
Static Sling: A strip of tissue, either the patient’s own tissue or synthetic tissue, is sewn under the skin to lift the corner of the mouth to match the other side
Dynamic Sling: A procedure that moves the temporalis tendon to the corner of the mouth to generate proper muscle movement and achieve a smile

Facial Paralysis Refinement

Mid-face Lift: A procedure that can balance the face and and tighten drooping and/or excess skin
Neck Lift: A procedure that eliminates drooping jowls and tightens the muscles and skin of the neck

Schedule A Consultation To Treat Facial Paralysis

If you are experiencing partial or total facial paralysis, contact us to schedule an appointment today.

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FAQs About Facial Paralysis (Bell’s Palsy)

What are risk factors for developing Bell’s palsy?

Bell’s palsy is more likely to occur in individuals who are pregnant, have recently given birth, have an upper respiratory infection, or have diabetes.³

Can physical therapy help restore facial movement?

In addition to surgical treatments to address function and cosmetic issues, physical therapy may provide some improvement in facial nerve function.⁴

Can you recover from facial paralysis?

Recovery depends on the cause and the extent of the nerve damage. While most patients make a full recovery from Bell’s palsy, it can take up to six months.⁵

Sources

¹ Johns Hopkins Medicine. Bell’s palsy. Available: https://www.hopkinsmedicine.org/health/conditions-and-diseases/bells-palsy/. Accessed July 23, 2021.

² Cleveland Clinic. Bell’s Palsy. Available: https://my.clevelandclinic.org/health/diseases/5457-bells-palsy. Accessed July 23, 2021.

³ Mayo Clinic. Bell’s Palsy. Available: https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028. Accessed July 23, 2021.

⁴ NIH. Bell’s Palsy Fact Sheet. Available: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet. Accessed July 23, 2021.

⁵ Cleveland Clinic. Bell’s Palsy. Available: https://my.clevelandclinic.org/health/diseases/5457-bells-palsy. Accessed July 23, 2021.

The Doctors at My Houston Surgeons have either authored or reviewed and approved this content. Page last updated: February 27, 2025

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