Have you noticed a crooked smile, difficulty closing one eye or loss of facial movement?
Our multidisciplinary team, with extensive experience in the field, will help you find the most appropriate facial paralysis treatment based on the stage of the condition, with the goal of helping you regain your smile.
What is facial paralysis?
Facial paralysis is the partial or complete loss of movement of the facial muscles caused by an impairment of the facial nerve.
It may appear suddenly or develop as a result of a disease, infection, trauma or certain surgical procedures. In some cases, it affects only part of the facial musculature; in others, it involves an entire side of the face.
The most common symptoms of facial paralysis include a crooked smile, difficulty fully closing the eye, loss of facial expression, excessive tearing, drooping of the corner of the mouth or a sensation of weakness in the face.
Although many people search for information about so-called stress-related facial paralysis, the reality is that facial paralysis can have many different causes, and an accurate diagnosis is essential to determine the most appropriate treatment.
Peripheral facial palsy or central facial palsy?
One of the first questions the specialist must answer is whether the condition is a peripheral facial paralysis or a central facial paralysis.
· Peripheral facial paralysis is the most common form and occurs when the facial nerve can no longer properly transmit nerve signals to the facial muscles. In these cases, the entire side of the face is usually affected, including the forehead and eyelid.
· Central facial paralysis, on the other hand, is usually associated with neurological conditions such as stroke and primarily affects the lower part of the face.
Distinguishing between these two situations is essential to establish the correct diagnosis and define the most appropriate treatment.
Symptoms of facial paralysis
The symptoms of facial paralysis may vary depending on the cause and severity of the injury, but they often appear suddenly and can be highly distressing. Patients commonly describe a crooked smile, difficulty moving one side of the face, inability to fully close the eye, facial weakness or a sensation of facial asymmetry when speaking or eating.
Facial paresthesia, a tingling sensation in the face, taste disturbances, excessive tearing and increased sensitivity to certain sounds may also occur. One of the most characteristic signs is the so-called Bell’s phenomenon, which occurs when the patient attempts to close the affected eye and the eyeball rolls upward due to muscle weakness.
8 most common symptoms of facial paralysis
Crooked smile
Facial asymmetry
Inability to close the eye
Facial weakness
Loss of facial expression
Excessive tearing
Taste disturbances
Facial paresthesia
Why does facial paralysis occur?
The most common cause of facial paralysis is known as Bell’s palsy or idiopathic facial paralysis, which develops suddenly without a clearly identifiable cause.
However, facial paralysis may also be associated with viral infections, trauma, tumours, neurological disorders or certain surgical procedures. In fact, many of the complex cases of facial paralysis we treat are the result of surgery performed to remove skull base tumours or acoustic neuromas, where the facial nerve may be affected during treatment.
For this reason, when facial paralysis does not progress favourably, it is essential to carry out a specialised assessment to identify its underlying cause and evaluate the different treatment options available.
Can facial paralysis be cured?
This is one of the most frequently asked questions among patients.
The answer depends on the cause, the severity of the injury and the time that has elapsed since its onset.
Many patients recover part or all of their facial mobility during the first few months. However, in other cases, sequelae such as facial asymmetry, muscle weakness, an incomplete smile or involuntary movements known as synkinesis may persist.
The good news is that today there are treatments capable of significantly improving both facial function and appearance, even in patients with permanent facial paralysis.
The earlier a facial paralysis that is not recovering properly is assessed, the greater the range of treatment options available.
Facial paralysis treatment: what options are available?
Facial paralysis treatment depends on the underlying cause, the time elapsed since onset and the degree of damage to the facial nerve.
There is no single solution that is appropriate for every patient. For this reason, each case requires an individual assessment to design a personalised treatment strategy.
For some patients, medical treatment and specialised follow-up will be sufficient. In other cases, advanced facial rehabilitation or surgical techniques may be necessary to restore facial movement and symmetry.
Medical treatment for facial paralysis
Medical treatment is usually the first therapeutic approach during the early stages of facial paralysis.
Depending on the cause, corticosteroids, antiviral medications or other treatments aimed at reducing inflammation of the facial nerve may be used to promote facial paralysis recovery and prevent potential complications.
During this phase, it is also important to carry out a comprehensive diagnostic evaluation to identify the cause of facial paralysis and determine the likelihood of recovery.
Specialised facial rehabilitation
Rehabilitation is one of the fundamental pillars of facial paralysis treatment.
Through neuromuscular re-education programmes, specific exercises and advanced facial rehabilitation techniques, it is possible to improve muscle coordination, restore facial movements and reduce both functional and aesthetic sequelae.
Facial paralysis rehabilitation also plays a key role in the treatment of synkinesis, involuntary movements that may occur during facial nerve recovery and affect everyday actions such as smiling or closing the eyes.
In many patients, early and properly guided rehabilitation can significantly improve functional outcomes.
Treatments to protect the eye
The inability to fully close the eye is one of the most common consequences of facial paralysis.
When the eyelid does not close properly, the ocular surface remains exposed, increasing the risk of dry eye, irritation and corneal damage. For this reason, treatment may include artificial tears, ophthalmic ointments, eye protection measures and, in some cases, surgical procedures designed to improve eyelid closure.
Among the most commonly used techniques are eyelid weights and various reconstructive procedures that help protect the eye and improve its function.
Facial paralysis surgery
When spontaneous recovery does not occur or when facial paralysis sequelae continue to affect facial function and quality of life, surgical treatment may be considered.
Facial paralysis surgery encompasses a range of procedures designed to improve facial symmetry, restore lost functions and recover movements as important as smiling or closing the eye.
The choice of surgical technique will depend on the cause of the injury, the time elapsed since its onset and the condition of the facial muscles.
Facial reanimation surgery
Facial reanimation surgery represents one of the greatest advances in the treatment of permanent facial paralysis.
Its goal is to restore movement to a face that has lost the ability to receive nerve signals properly. To achieve this, nerve transfers, nerve grafts, muscle transfers and other advanced facial reconstruction techniques may be used.
These procedures can partially restore facial mobility, improve the smile and create a more natural facial expression, significantly contributing to a better quality of life for patients.
Why treat your facial paralysis at barnaclínic+?
Choosing where to receive treatment for facial paralysis is an important decision. It is not only about restoring facial movement, but also about smiling again, protecting the eye, recovering facial expression and improving quality of life.
At barnaclínic+, our approach is based on clinical expertise, personalised assessment and a multidisciplinary model that integrates diagnosis, rehabilitation and specialised surgery.
Medical expertise and multidisciplinary approach
Facial paralysis can have many different causes and affect each patient in a unique way. For this reason, its treatment requires collaboration between professionals with specific expertise in diagnosing and restoring facial function.
At barnaclínic+, we work in a coordinated manner with specialists in Physical Medicine and Rehabilitation, Maxillofacial Surgery, Plastic and Reconstructive Surgery, Neurosurgery, Neurology, Ophthalmology and Otolaryngology (ENT), allowing us to provide a comprehensive assessment and a personalised treatment plan for each patient.
Our goal is to identify the cause of the injury, evaluate the real possibilities for recovery and select the most appropriate treatment at every stage of the condition.
All treatment options within a single unit
Not all patients require the same facial paralysis treatment.
Some cases of facial paralysis can recover with medical treatment and specialised follow-up. Others require advanced facial rehabilitation programmes to restore movement or manage the sequelae caused by nerve injury.
When spontaneous recovery does not occur or significant functional limitations persist, we offer reconstructive surgery and facial reanimation procedures aimed at restoring the smile, improving facial symmetry and recovering lost function.
Having access to all therapeutic alternatives within the same unit allows decisions to be made solely according to each patient's needs.
Specialists in facial functional recovery
The face is not only important for appearance. It plays a fundamental role in communication, expressing emotions, eating, drinking, speaking and protecting structures as important as the eye.
For this reason, our approach focuses on the functional recovery of facial paralysis, combining specialised rehabilitation with personalised treatments designed to improve mobility, muscle coordination and quality of life.
The ultimate goal is not simply to improve facial appearance, but to help patients regain everyday functions such as smiling naturally and fully closing the eye.
Expertise in facial reanimation surgery
Facial reanimation surgery is one of the most complex and specialised areas within the treatment of facial paralysis.
Our team has extensive experience in advanced techniques such as nerve transfers, facial suspension procedures, surgeries to improve eyelid closure and other strategies aimed at restoring movement and the ability to smile in patients with permanent facial paralysis.
These techniques make it possible to offer solutions even in complex cases resulting from trauma, tumours, acoustic neuromas or sequelae of previous surgeries.
Part of the Hospital Clínic de Barcelona environment
barnaclínic+ is part of the healthcare environment linked to Hospital Clínic de Barcelona, one of the leading national and international centres for the treatment of neurological, neurosurgical and other highly complex conditions.
The diagnosis and treatment of facial paralysis are based on updated protocols, advanced technology and robust scientific evidence, ensuring a safe approach aligned with the highest standards of modern medicine.
Frequently asked questions about facial paralysis
Will my face return to normal after facial paralysis?
Facial paralysis can be treated and, in many cases, cured, depending on the cause of the injury, its severity and how quickly treatment is started. Many people recover a large part of their facial mobility, while others may retain some degree of asymmetry or functional limitation. When recovery is not complete, there are treatments available that can improve both facial function and appearance.
Can stress cause facial paralysis?
Although many people refer to “stress-related facial paralysis”, stress is not usually the direct cause of facial nerve damage. On its own, stress is not generally considered the direct cause of facial paralysis. However, it may contribute to certain clinical situations and act as a triggering or contributing factor in some individuals. Whenever there is a loss of facial movement, a medical evaluation is recommended to rule out other causes that may require specific treatment.
What should I do if I suddenly notice that my mouth is crooked?
The sudden appearance of a crooked smile or difficulty moving one side of the face requires medical assessment as soon as possible. Some neurological conditions can produce similar symptoms and must be ruled out urgently.
Is it normal for the eye to water constantly?
Yes. When the facial muscles lose strength, blinking may become less effective and the eye loses part of its natural protection. This can lead to excessive tearing, a gritty sensation, irritation and visual discomfort.
Why do some people recover movement while others do not?
The ability to recover depends on factors such as the cause of the injury, the degree of damage to the facial nerve, the patient's age and the time elapsed since symptoms first appeared. This is why an individualised assessment and specialised follow-up are so important.
Can long-standing facial paralysis be improved?
Yes. Even if months or years have passed since the injury occurred, there are treatments aimed at improving certain sequelae. The potential for recovery depends on each individual case, but the length of time since the injury does not automatically rule out treatment options.
Does facial paralysis only affect the ability to smile?
No. In addition to affecting the smile, it can interfere with important functions such as closing the eye properly, retaining saliva, pronouncing certain sounds, drinking liquids and expressing emotions through facial gestures.
What is synkinesis?
Synkinesis refers to involuntary movements that may appear in some people during facial nerve recovery. For example, smiling may cause the eye to close partially, or blinking may trigger movement at the corner of the mouth. This is a relatively common sequela and can be treated through specialised rehabilitation and other complementary therapies.
Is it possible to smile naturally again?
There are currently several therapeutic strategies designed to improve movement of the corner of the mouth and restore a more balanced smile. The most appropriate option will depend on the cause of the injury, the time since onset and the condition of the facial muscles.
How does facial paralysis affect daily life?
Beyond the physical symptoms, many people experience changes in self-esteem, social interactions and confidence when speaking in public, smiling or having their photograph taken. For this reason, modern facial paralysis treatment aims not only to improve facial function, but also to enhance the patient's overall well-being and quality of life.
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