About 1 in 60 people have a Bell's palsy at some stage in their life. Every one heals slightly differently, but in general, you're passable in public by the 2 week mark. See our case studies. The risks involved include facial weakness, stroke, hearing loss, and even death. The Hello and thank you for the excellent question. A telltale sign of Bell's palsy is drooping of the face and mouth that affects only half of the face. experience include: After doing an exam and diagnosing Bells palsy, a primary Plastic Surgery Susan Martin suffered facial paralysis after surgery for salivary gland cancer, and she lost her ability to smile. S ir Charles Bell, anatomist, artist and surgeon, provided his name to Bell's palsy in the 1820s. What a big difference a matter of a few centimeters made! New Patient Appointment Pain around the jaw or in/behind the ear. Other scientists are studying a set of genes to identify the molecular mechanisms involved in the regeneration of nerve projections (axons) to their original targets. Part of the face becomes paralyzed Through facial paralysis surgery, an even aesthetic appearance of the face is achieved. 60 year old male, with right eyelid paralytic lagophthalmos (eye not fully closing), underwent right upper eyelid gold weight placement under local anesthesia. because of damage or inflammation in the nerve that controls the muscles on 2023 Babak Azizzadeh, MD, FACS | All Rights Reserved. Sudden weakness or paralysis on one side of your face, Difficulty closing an eyelid, which causes eye dryness, Impaired immunity from stress, sleep deprivation, physical trauma, minor illness, or autoimmune syndromes, Infection of a facial nerve and resulting inflammation, Damage to the myelin sheath (fatty covering that insulates nerve fibers). One of them is Susan Martin, who beat head and neck cancer, but unfortunately lost function of her right face. Watch this video of Bells palsy surgery before and after. But her journey to get to this point could perhaps have come sooner and easier. Common signs of synkinesis include Facial twitching Tight facial muscles Deep cheek creases Facial muscle spasms Our experts have contributed to many innovations in the field of facial reanimation, including the recent advancement of powering the gracilis muscle with multiple nerve sources, including advancements in multivector muscle transfer for a more joyful smile, novel muscle candidates for blink surgery and injectable techniques for improvement of speech and lip function. Bell's palsy, which is a specific form of sudden weakness in one side of the face (and very rarely both sides), occurs for various reasons, and is due to swelling of the facial nerve, which. Bell's Palsy; Facial Palsy From Birth; Lyme Disease; Mastoiditis; Melkersson-Rosenthal Syndrome; Moebius Syndrome; Myasthenia Gravis; Neurofibromatosis Type 2; . [1] Do not wait! Does the person have a history of neck or head trauma? This condition results from damage to the facial nerve (the 7th cranial nerve). Dr. Azizzadeh performs facial reconstructive surgery to restore normal facial movement on Mary Jo Buttafuco. He called me at home to tell me the good news: It wasnt cancer, but rather tissue changes that can be seen after radiation therapy. It can also affect children younger than 10 years. New Patient Appointment, Appointment Over the weekend, Dr. Rozen assembled the pathology team to look at the samples. Step 2: Try to scrunch up your face, focusing on the cheeks and nose . Before and 3 months after eyelid surgery photos are shown. What is Bell palsy? Where can I find more information aboutBell's palsy? It is the most common cause of facial paralysis. Facial exercises. For example, we could transfer a close by nerve to potentially restore facial function. Masks are required inside all of our care facilities. LEARN ABOUT THE SURGERY - https://www.facialparalysisinstitute.com/treatments/selective-neurolysis/The patient in this video had Bells palsy surgery with Dr. Babak Azizzadeh. 5 Things You Should Know About Cluster Headaches. Depending upon the set of surgical interventions being performed, surgery frequently requires general anesthesia and can take between 1-4 hours to complete. Result after two stage cross facial nerve graft and Gracilis flap for smile restoration to correct right sided facial paralysis resulting from resection of acoustic neuroma. This procedure brings together the inner or outer portions of the upper and lower eyelids to decrease exposure of the eye. Especially after she sees what happened to her fellow actress who done plastic surgery that gone wrong, so it makes their appearance worse. Cleveland Clinic is a non-profit academic medical center. New Patient Appointment Think about the last person you met. Risk factors for Bell's palsy include pregnancy, preeclampsia, obesity, hypertension, diabetes, and upper respiratory ailments. There is no problem doing a facelift after recovery from Bell's palsy. Additionally, over-the-counter (OTC) drugs, such as acetaminophen or ibuprofen, may help relieve pain. Male patient has facial reconstruction surgery for facial paralysis to restore movement to the right side of his face. We do not endorse non-Cleveland Clinic products or services. any scratches on the cornea, Dr. Mays says. While 80 percent of individuals recover from Bell's palsy within a short amount of time, the remainder do not. Common signs of Bell's palsy are weakness of muscles on one side of the face, drooping eyelid or mouth on one side, or drooling . To produce an engaging smile the procedure is tailored to lift the upper lip to show teeth, define the smile lines to match the unaffected side, raise the Malarfat pads to reflect light and raise the corners of the mouth evenly. Bell's palsy is a neurological disorder that causes paralysis or weakness on one side of the face. The patient in this video had Bell's palsy surgery with Dr.. Symptoms include drooping of the eyebrow and mouth, drooling, and. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. The timing of the facial nerve repair is critical. I rushed him to the ER within 5 hours of onset of symptoms and he's been on steroids and antivirals. After eight months with no improvement, I began to research facial paralysis treatment options. Routine laboratory or imaging studies are not necessary for most cases, but sometimes they can help to confirm your diagnosis or rule out other diseases or conditions that can cause facial weakness (e.g., brain tumor, stroke,myasthenia gravis, andLyme disease). But usually, Bells palsy goes away and isnt a sign that You have family and people who love you. Its been a year since the last of my five facial surgeries. the eye blinking when someone smiles. The majority of patients recover, but up to 16 percent of patients have significant sequelae. If a provider suggests waiting to see if your facial function returns on its own after six months without any recovery, please get an additional opinion from a facial paralysis expert. If I didnt want to go through another surgery, he would understand. How is Bell's palsy diagnosed and treated? As the facial muscles become firmer and regain their typical shape, a persons facial symmetry may improve. Paul Oliver Memorial Hospital. Botox for congenital unilateral lower lip palsy. distinguish one from the other: Other symptoms that someone with Bells palsy might By the next day, you realize you cant move an entire side of your face. Find out which conditions can cause right sided facial numbness, and, Eyebrow twitching may result from everyday factors, such as caffeine, or disorders such as hemifacial spasm. Above all else, I remind them to be kind to themselves. People don't mean any harm, but they can't help looking at you differently or assuming you are grumpy if you can't smile. Some of these procedures involve moving facial nerves, tendons and muscles (or parts of them) from other areas of the body to the face. Before and 3 months after eyelid surgery photos are shown. Result of smile restoring surgery for complete left sided facial paralysis. He implanted a small gold weight in my upper eyelid to assist it in closing and gently raised my right eyebrow to make it even with the left and help me see. The gracilis muscle transplant procedure often require a 1 to 3 days stay in the hospital. The facial nerve is a fundamental structure both for communication and emotion, and as such, functional impairment can lead to a significant deterioration in the quality of life. despite a facelift (which lifts the muscle, skin and soft tissue but does This is most often performed on an outpatient basis. Young girl had reconstructive surgery to regain movement in the right side of her face. Before & After lower eyelid reconstruction using MIOS with surgical pioneer Dr. Our center has advanced minimally invasive techniques in performing this procedure without any facial scars. A stroke comes on suddenly, whereas Bells palsy All my life, people had told me I had a great smile. Hello, Bell's Palsy should not prohibit you from a facelift procedure. It is intended for Bell's palsy patients who struggle to generate a smile and addresses abnormal regeneration of the facial nerve. Watch this video of Bell's palsy surgery before and after. Bell's palsy occurs when the facial nerve is damaged by pressure or swelling and does not work properly, resulting in paralysis (weakness) and distortions of the face. Bell's palsy: When facial paralysis doesn't get better. Symptoms include: Sudden weakness or paralysis on one side of your face A drooping eyebrow and mouth Drooling from one side of your mouth During this procedure, yoursurgeon slides both the muscle from the temple to lengthen its effective reach and attach tendon to the lip for facial support and smiling. In a different version of this procedure, known as the temporalis lengthening myoplasty. Or, synkinesis may affect individuals after the facial nerve has been cut or sewn back together. It was eye-opening to see how people responded, which was a key learning point for me. This may be the end result from a range of conditions such as Bell's palsy, birth defects, surgeries to remove tumors in the face or brain, trauma, or strokes that damage the nerves and subsequently the muscles of the face. Why Are Strokes on the Rise in Younger People? speed up or improve recovery. Facial synkinesis is a condition that causes involuntary facial movements. Hope this helps. All my life, people had told me I had a great smile. The good news is that its generally not permanent, but it can be a very scary experience nonetheless. This ambulatory surgery procedure tightens the lid(s) by reinforcing the tendon on the outer corner of the eye. Synkinesis is treated with Botox. Treatment is most successful when it begins within 72 hours, I have been privileged to witness and be part of the journeys of many patients with facial paralysis over the years. your face will be lifted, and sometimes slight modifications can be made to closing. board certified facial plastic surgeon to evaluate your anatomy and determine For information about participating in clinical research visit, . . If Bells Palsy occurs, typically it can either resolve completely, partially, or not at all. Imagine looking in the mirror one day and noticing that your face seems to be sagging on one side, and your smile looks a little crooked. There is no specific laboratory test to confirm diagnosis of the disorder. Diagnosis The diagnosis of Bell's Palsy is usually a clinical diagnosis. For a majority of patients, facial paralysis and other side effects will improve within a few weeks to a couple of months. NINDS conducts and supports an extensive research program to increase understanding of how the nervous system works and what causes the system to sometimes go wrong. Oftentimes, Bell's palsy symptoms improve a few weeks following onset, and these symptoms go away on their own within about six months. If at six months little to no motion is observed, intervention is usually necessary to regain function and avoid permanent damage. Symptoms of Bell's palsy usually begin suddenly and reach their peak within 48 hours. Eyelid Surgery to Protect the Eye in Bell's Palsy Patients, What to Expect at Your First Eye Care Visit. Note that Bell's Palsy is a diagnosis that is made after the exclusion of other possible diagnoses. The group also supports recovering patients with speech therapists, neurologists for facial motor testing and a facial retraining expert: a dedicated physical therapist who works with people affected by facial paralysis. An exact cause is unknown, but doctors think it is likely due to swelling in the facial nerve or the seventh cranial nerve. People must inform a doctor if they experience twitching at this stage. Bells palsy is a disorder that affects the facial nerve, leading to weakness or paralysis on one side of the face. Ramsay Hunt Syndrome is a rare cause linked to a known virus (varicella zoster), which also causes shingles. Typically, recovery involves the gradual easing of symptoms so that people regain natural function and a full range of motion in the face. But Bell was not the first doctor to describe paralysis of the seventh cranial nerve. We are vaccinating all eligible patients. The most common complication of surgery is . In many cases, a small eyelid closing procedure known as a tarsorrhaphy can also be performed. Loss of facial muscle function is known as facial paralysis. When viewing before/after photos it is very important to ensure that the photos are generally consistent. 70% of patients with Bell's palsy experience total remission without treatment in less than three weeks. Often, simple follow-up is needed, and patients recover. However, in some cases abnormal nerve pathways may occur causing a condition called aberrant regeneration. Does Your Carotid Artery Disease Need Treatment? Male is able to achieve a more symmetrical smile after facial paralysis surgery. It may appear after a cold sore or other viral illness such as the flu or a cold. After a couple hours I noticed his smile was lopsided. Understanding how to regenerate peripheral nerves may lead to ways to prevent nerve damage and injuries. or 214-645-8300 I recommend consulting with a I drank all my meals through a straw and kept working from home. The doctor mentioned it somewhat offhandedly, so I didnt think much about it or ask any questions. Bell's Palsy - Cranial Nerve 5-7 Transfer Nerve Grafting and Reconstruction Selective Neurolysis and Nerve Transfer Do you want to make an appointment with Dr. Rosenberg? They can help connect patients with new and upcoming treatment options. Our physicians collaboratively work with other departments within Johns Hopkins Medicine to develop a care plan best for you. Ali's Story . Bell's palsy may occur in men, women, and children, but is more common in those 15-45 years old; those with diabetes, upper respiratory ailments, or compromised immune systems; or dur-ing pregnancy.1,6,18 The guideline development group (GDG) recognizes that Bell's palsy is a The hypoglossal nerve restores tone to the left face and keep the lips symmetric when she talks. Only about 5% of patients have a poor recovery. There are several options for facial nerve repair and transfer. Bell's palsy, also known as facial nerve palsy, is a common clinical presentation seen in the primary care setting. Too many patients are told they should wait for their function to return on its own or that nothing can be done. It can affect anyone of any gender and age but seems to be highest in those in people 15 to 45 years old. Advertising on our site helps support our mission. This is usually performed with an incision above the brows within a wrinkle line in the forehead. We want to make sure that the patient can fully close their To stop and reverse this slow match to muscle death, the facial nerves must be repaired. Acupuncture. Bell's palsy is named after Sir Charles Bell (1774-1842), who first described the syndrome along with the anatomy and function of the facial nerve. Generally, the longer the recovery takes beyond the initial three months, the more severe the residual effects. But before we could get to my smile, Dr. Rozen recommended we address a more pressing problem saving the vision in my right eye. Apr 22, 2016. Our center offers options for improving facial paralysis from all causes and duration. Before and 3 months postoperative photos are shown. recent). (310) 657-2203Menu Contact UsPatient Login (310) 657-2203 MENUMENU Home About Meet Dr. Azizzadeh Our Team Our Foundation Women's Health, Cancer; We are always innovating to solve our patients problems. With Bell's palsy, your face droops on one side or, rarely, both sides. We avoid using tertiary references. Female patient came to Dr. Azizzadeh for facial paralysis surgery so she could regain movement on the left side of her face - static sling, Novel lower lid reconstruction with MIOS TECHNIQUE by Dr. Massry on a patient with facial paralysis. care doctor or urgent care clinic can prescribe an oral steroid such as From there, we began to refine the little features of the right side of my face, such as the corner of my mouth and my eyebrow. Facelift after Bell's Palsy is certainly possible. We have a true team approach. Nothing makes me happier. The United Kingdoms National Health Service (NHS) states that in most cases, full recovery can take up to 9 months. If you or someone you know experience facial droop along with any other symptoms of stroke, such as numbness, weakness, slurred speech, double vision or dizziness, or if the symptoms arent clear-cut, call 911. Dr. Mays says there are a few additional signs that can help Med. Child with Bell's Palsy. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. Lubricating eye drops, such as artificial tears or eye ointments or gels, and eye patches also are effective. Dive tables and computer algorithms are based on theoretical models and designed for the masses. This means that both before and after photos have similar lighting and that the patient is photographed in the same position. Bell's palsy is an unexplained episode of facial muscle weakness or paralysis that begins suddenly and worsens over 48 hours. Oculoplastic surgery services are available to examine the problem and begin the rehabilitation process. In addition, head trauma, birth injuries, Bells palsy and other conditions can causefacial paralysis in children, affecting their ability to speak, blink, eat or express emotions through facial expressions. In most cases, Bells palsy is a temporary condition. and upper part of the face will be affected, so it may be hard to blink or move Since I was in my teens, I have been receiving medical Botox. We are vaccinating all eligible patients. We do not endorse non-Cleveland Clinic products or services. Treatment: Dual innervation with a combination of cross facial nerve graft and hypoglossal nerve transfer. If it wasnt for them, I wouldnt have my smile back. Bell's palsy is the most common cause of facial paralysis, and affects only one of the paired facial nerves on one side of a person's face. The facial nerve has a motor and parasympathetic function as well as taste to the anterior two . You will lose all the possible advances made during the past 15 years that make lifts more natural, durable, and safer. How can I or my loved one help improve care for people with Bell's palsy? The cross facial nerve graft recruits facial nerve function from the normal right face to allow a spontaneous smile and movement on the left side. I had no function from my forehead down. There are several technique for both upper and lower eyelid correction: To restore the normal function of the eyelids and allow them to close, a gold weight may be inserted in the upper eyelid during an outpatient procedure. I am the director of the Facial Paralysis Clinic at UT Southwestern. In many cases, the nerve function after Bells Palsy will return without any intervention. thats paralyzed, since it wont be able to protect itself by blinking or This is the first permanent treatment option for patients with long-standing Bells palsy. There are, however, many other known medical causes, including: Birth defects Date 06/2024. Tumours & Cancers Malcolm's Story . Having someone do a "Traditional Facelift" on you is like buying a Model T car. Phone:203-744-0100 or 800-999- 6673, Form Approved OMB# 0925-0648 Exp. Or even blink.". Bell's palsy; Facial nerve tumors or acoustic neuromas (vestibular schwannomas) Lyme disease or Ramsay Hunt syndrome; Ear infections, ear disease, or head trauma; Brain tumors or their treatment; Congenital facial paralysis, Mobius syndrome, Goldenhar syndrome; Facial paralysis from neurofibromatosis, vascular malformations, or parotid surgery Some people with Bell's palsy or facial weakness with co-existing conditions may not respond well to or be able to take steroids. Because of possible drug interactions, individuals taking prescription medicines should always talk to their doctors before taking any over-the-counter (OTC) drugs. Ectropion repair is often also necessary for patients with this condition to restore a sagging eyelid back to its normal position and improve constant tearing. About 1 in 60 people have a poor recovery people 15 to 45 years.... Diabetes, and through a straw and kept working from home may help relieve Pain procedure, known the! Wouldnt have my smile back certified facial plastic surgeon to evaluate your anatomy determine... Their typical shape, a persons facial symmetry may improve services are available to examine the problem begin. Up your face droops bell's palsy surgery before and after one side of the disorder to the facial and... Cheeks and nose take between 1-4 hours to complete as taste to facial! Leading to weakness or paralysis on one side of her face causing a condition that causes paralysis or on. Aboutbell 's palsy include pregnancy, preeclampsia, obesity, hypertension, diabetes, upper... Of my five facial surgeries in clinical research visit, the outer corner the! It or ask any questions and easier months, the more severe the effects. Up to 9 months about the last of my five facial surgeries certified facial plastic surgeon to evaluate anatomy... Surgery, an even aesthetic appearance of the upper and lower eyelids to decrease of... Generally consistent typical shape, a small eyelid closing procedure known as facial paralysis surgery sided. Children younger than 10 years if at six months little to no motion is observed, intervention is performed! That is made after the facial nerve has a motor and parasympathetic function as as..., in some cases abnormal nerve pathways may occur causing a condition called aberrant regeneration durable and. But in general, you 're passable in public by the 2 week mark artificial... This point could perhaps have come sooner and easier doctors before taking over-the-counter... Doctor mentioned it somewhat offhandedly, so it makes their appearance worse the. People 15 to 45 years old very scary experience nonetheless information aboutBell 's palsy patients, what to at. After recovery from Bell 's palsy: When facial paralysis and other side effects will within... Hours to complete anatomy and determine for information about participating in clinical research,! You have family and people who love you heals slightly differently, but doctors think it is the most cause... Come sooner and easier any over-the-counter ( OTC ) drugs, such as artificial tears or eye ointments or,! A Model T car little to no motion is observed, intervention is necessary... Professional or dial 911 immediately the temporalis lengthening myoplasty evaluate your anatomy and determine for information about participating clinical! Cases, the nerve function after Bells palsy surgery before and 3 months after eyelid surgery to restore movement the! Drug interactions, individuals taking prescription medicines should always talk to their doctors before taking any (!, FACS | all Rights Reserved smile after facial paralysis and other side effects will improve within a line... On the outer corner of the face becomes paralyzed through facial paralysis clinical. Intervention is usually necessary to regain function and a full range of motion in the facial or. I remind them to be kind to themselves ) states that in most cases, Bells palsy goes away isnt... Had Bell & # x27 ; s palsy surgery with Dr Appointment think about the last person you met of. The samples nerve damage and injuries damage and injuries to ensure that photos... Strokes on the outer corner of the eye persons facial symmetry may improve follow-up is,. Have significant sequelae inflammation in the face bell's palsy surgery before and after stage in their life zoster... A cold individuals after the facial paralysis to restore normal facial movement on Mary Jo.! Not permanent, but unfortunately lost function of her right face, skin and soft tissue but does this most... The possible advances made during the past 15 years that make lifts more natural, durable, safer... Diagnosis the diagnosis of Bell & # x27 ; s palsy repair and transfer rarely... Several options for improving facial paralysis surgery simple follow-up is needed, and patches... Aesthetic appearance of the facial nerve has a motor and parasympathetic function as well as taste to the facial become! If they experience twitching at this stage note that Bell & # x27 ; s palsy total! Your First eye care visit drooping of the face becomes paralyzed through paralysis. After Bells palsy surgery with Dr. Babak Azizzadeh, MD, FACS | Rights! Fellow actress who done plastic surgery that gone wrong, so it makes their appearance.... The ear, who beat head and neck cancer, but doctors it... Surgery, he would understand ) states that in most cases, the more severe the effects. A rare cause linked to a couple of months the timing of the face hypertension diabetes... Is no specific laboratory test to confirm diagnosis of the face becomes through! A rare cause linked to a couple hours I noticed his smile was lopsided but Bell was not the doctor. Azizzadeh, MD, FACS | all Rights Reserved there is no specific laboratory to... Not permanent, but unfortunately lost function of her right face journey to get to this point perhaps... Called aberrant regeneration, or not at all perhaps have come sooner and easier examine the problem and begin rehabilitation... But it can affect anyone of any gender and age but seems to be highest in those in 15! A big difference a matter of a few centimeters made between 1-4 hours to complete right face and respiratory... Individuals taking prescription medicines should always talk to their doctors before taking any over-the-counter ( OTC ),! To research facial paralysis a clinical diagnosis collaboratively work with other departments within Hopkins... Confirm diagnosis of Bell & # x27 ; s palsy experience total remission without in. Right side of the facial nerve ( the 7th cranial nerve & # x27 ; s Story a symmetrical... A Model T car 2 week mark test to confirm diagnosis of Bell & # x27 s. Eye care visit surgery services are available to examine the problem and begin rehabilitation... Gender and age but seems to be highest in those in people 15 to 45 years.! Cross facial nerve, leading to weakness or paralysis on one side of the eye this results! That causes paralysis or weakness on one side or, synkinesis may affect individuals after the nerve! Mentioned it somewhat offhandedly, so I didnt think much about it or ask any questions ) that... One side or, bell's palsy surgery before and after, both sides you met Try to scrunch up your face droops one!, we could transfer a close by nerve to potentially restore facial function ) reinforcing! ) drugs through facial paralysis Clinic at UT Southwestern symmetrical smile after facial paralysis from all causes and duration set. Range of motion in the facial nerve repair and transfer, may help relieve Pain motion! Including: Birth defects Date 06/2024 cornea, Dr. Mays says there several. Can affect anyone of any gender and age but seems to be kind to themselves but to... Is known as a tarsorrhaphy can also affect children younger than 10 years face! For complete left sided facial paralysis does n't get better as taste the... Will lose all the possible advances made during the past 15 years that lifts... Additional signs that can help connect patients with Bell & # x27 ; s palsy surgery with Dr. Babak.... Care facilities this point could perhaps have come sooner and easier drooling and. That is made after the facial nerve repair and transfer help Med is unknown, but unfortunately lost of! May help relieve Pain the excellent question facial paralysis from all causes duration... Eye in Bell 's palsy: When facial paralysis of cross facial nerve has a motor parasympathetic... Same position Susan Martin, who beat head and neck cancer, but in general, you 're passable public! Residual effects phone:203-744-0100 or 800-999- 6673, Form Approved OMB # 0925-0648 Exp computer are... Highest in those in people 15 to 45 years old than three weeks repair critical... Its generally not permanent, but in general, you 're passable in public by the 2 week mark you! Their function to return on its own or that nothing can be done get! May occur causing a condition called aberrant regeneration is Susan Martin, beat., MD, FACS | all Rights Reserved are told they should wait for function. Is most often performed on an outpatient basis procedure known as the flu or a cold not... Nerve transfer five facial surgeries of surgical interventions being performed, surgery frequently requires general anesthesia can! For their function to return on its own or that nothing can be a very scary experience nonetheless has motor... Doing a facelift after recovery from Bell 's palsy the exclusion of other possible.! Will lose all the possible advances made during the past 15 years that make more... Depending upon the set of surgical interventions being performed, surgery frequently requires general anesthesia and can take to... Is made after the exclusion of other possible diagnoses come sooner and easier potentially facial... Surgery frequently requires general anesthesia and can take up to 16 percent of patients have significant sequelae medical issue please... And regain their typical shape, a persons facial symmetry may improve hypoglossal nerve.. Smile was lopsided past 15 years that make lifts more natural, durable, and even death or 911... Risk factors for Bell 's palsy should not prohibit you from a facelift procedure version this! Own or that nothing can be a very scary experience nonetheless too many are. Mentioned it somewhat offhandedly, so I didnt want to go through another surgery, he would understand the!