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Facial Nerve

The facial nerve, also known as the seventh cranial nerve or cranial nerve VII, is used to control facial expressions. It splits into five branches: cervical, mandibular, buccal, zygomatic and temporal. These branches spread across the face and work together to make facial expressions. They also are used for speech, chewing, and other basic facial functions. Additionally, the facial nerve is responsible for taste in the front two thirds of the tongue and mouth.

Babak Azizzadeh, MD, FACS is internationally recognized for his expertise in facial plastic surgery and complex facial nerve reconstruction procedures. He is Harvard-trained in aesthetic and reconstructive facial nerve surgery and attracts patients both nationally and internationally to the CENTER for Advanced Facial Plastic Surgery in Los Angeles, including those who require complex facial nerve treatments.

What Is Dr. Azizzadeh's Facial Paralysis Treatment Philosophy?

Facial paralysis treatment can be complex. Fortunately, Dr. Azizzadeh does everything in his power to provide facial paralysis patients with simple and effective treatment options.

Dr. Azizzadeh follows a holistic philosophy as he explores ways to treat facial paralysis. He carefully evaluates a patient and recommends a treatment tailored to him or her. Furthermore, Dr. Azizzadeh encourages his patients to share their concerns and questions regarding treatment. This ensures that Dr. Azizzadeh and his patient can work together to achieve the best-possible treatment results.

Meanwhile, Dr. Azizzadeh promotes patient education. He wants his facial paralysis patients to understand what to expect during treatment and what they can do to achieve long-lasting symptomatic relief. Therefore, Dr. Azizzadeh can discuss facial paralysis topics with his patients. And he verifies that his patients know what to expect at each stage of a facial paralysis treatment.

What Is Facial Nerve Paralysis?

Learn more about facial paralysis at The Facial Paralysis Institute.

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Facial nerve paralysis occurs when one or more branches of the facial nerve stops functioning properly. The condition makes it difficult for a person to make facial expressions and hinders their ability to chew, swallow, and speak.

There are many causes of facial nerve paralysis. Determining the root cause of an individual’s facial paralysis plays a key role in finding the right treatment.

As a foremost expert in facial nerve reconstruction, Dr. Azizzadeh has led the facial paralysis field and developed techniques to help patients reanimate their facial features. Dr. Azizzadeh is board-certified in facial plastic and reconstructive surgery, along with otolaryngology (head and neck surgery). He also is well-versed in virtually every aspect of cranial anatomy, including the critical facial nerve.

Much of Dr. Azizzadeh’s career has been spent researching and developing techniques to restore facial nerve function for those who have lost it to congenital deficiencies or trauma. As the Director of The Facial Paralysis Institute, Dr. Azizzadeh is recognized worldwide as a leading figure in the field of facial nerve paralysis.

After demonstrating incredible proficiency during his residency at the UCLA Center for Health Sciences, Dr. Azizzadeh was selected to complete a highly focused, sub-specialized fellowship in facial plastic and reconstructive surgery at Harvard Medical School. It was during this time that he began his crucial work to find quick, efficient, and safe ways to correct facial paralysis. Since that time, Dr. Azizzadeh has helped hundreds of patients with facial paralysis and demonstrates what is now possible in facial nerve reconstruction.

Before & Afters

Dr. Azizzadeh’s expertise in facial plastic and reconstructive surgery has made him one of the most sought-after physicians in the world. Click the button below to view before and after photos from some of Dr. Azizzadeh's recent facial paralysis treatments performed at the CENTER.

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Facial Paralysis Causes

There is no surefire cause associated with facial paralysis. Instead, facial paralysis is caused by any condition that damages the facial nerve. When facial nerve damage occurs, facial features innervated by the facial nerve become partially or completely dysfunctional.

Common causes of facial paralysis include:

    • Bell’s palsy
    • Trauma to the face
    • Excisional acoustic neuroma surgery
    • Ear or parotid surgery
    • Moebius syndrome (congenital neurological disorder)
    • Stroke or other disorders involving the central nervous system
    • Herpes Zoster Oticus (virus that affects the inner, middle and external ear)
    • Melkersson-Rosenthal Syndrome (rare neurological disorder)
    • Hemifacial microsomia (congenital disorder of the lower half of the face)
    • Infections of the middle ear
    • Lyme disease

In treating facial paralysis, Dr. Azizzadeh’s expertise allows for accurate diagnosis. He dedicates time and resources to learn about patients and their facial paralysis symptoms. Dr. Azizzadeh’s holistic approach to facial paralysis is crucial for effective treatment and enables him to provide a personalized treatment to each facial paralysis patient.

Facial Paralysis Symptoms

Facial paralysis symptoms vary from patient to patient. While most patients will know they have some degree of facial paralysis, there are some who have subtle symptoms. Regardless of the type or degree of symptom, it is imperative that such patients seek the help of a facial nerve specialist to discover their treatment options.

Common symptoms of facial paralysis include:

    • Inability to smile on one or both sides
    • Oral disability, including drooling or inability to chew
    • Depression of the eyebrows
    • Facial asymmetry
    • Inability to close one or both eyelids
    • Paralysis of lower eyelid
    • Damage to cornea
    • Drooping in the mid-face
    • Decreased tear production
    • Obstruction of nasal airway due to secondary external valve collapse
    • Lower lip deficit
    • Effacement of the nasolabial fold

For those who are dealing with one or more of the above symptoms, it is time to seek the care of a facial nerve specialist. As an internationally renowned expert in the facial nerve and treating facial paralysis, Dr. Azizzadeh is regularly sought out by both patients and peers from around the world. He helps his patients understand their condition and offers a partial or total solution to address their facial paralysis symptoms. In many cases, Dr. Azizzadeh uses innovative and comprehensive reconstruction techniques that other surgeons cannot provide.

How Dr. Azizzadeh Customizes Facial Reanimation Treatment

Dr. Azizzadeh understands facial paralysis can affect people in many different ways. To help a facial paralysis patient relieve their symptoms, he delivers a customized facial reanimation treatment.

A custom facial reanimation treatment accounts for a patient’s facial paralysis symptoms and other factors. It also ensures that a patient can get the help he or she needs to correct their facial paralysis and prevent it from recurring.

Dr. Azizzadeh works diligently to craft a personalized facial reanimation treatment plan for a patient. He may perform extensive testing to determine the best course of action to treat his patient’s facial paralysis. Dr. Azizzadeh does everything he can to execute his treatment plan with precision and care, too.

As Dr. Azizzadeh administers a custom facial reanimation treatment, he monitors his patient’s results. Dr. Azizzadeh requests follow-up appointments in the weeks and months following a facial reanimation procedure. He verifies that the treatment helps his patient correct their facial paralysis symptoms long into the future.

What Is Bell's Palsy?

Bell’s palsy represents one of the leading causes of facial paralysis. It refers to paralysis or weakness that impacts one side of the face.

Those with Bell’s palsy can experience immediate facial paralysis. In these instances, facial paralysis symptoms can crop up suddenly. However, Bell’s palsy generally disappears on its own within about three months of onset.

If Bell’s palsy symptoms linger, they can cause long-lasting problems. The symptoms can even reach a point where they lead to permanent facial paralysis.

Dr. Azizzadeh can treat patients who have been coping with Bell’s palsy for eight months or longer. At this point, Dr. Azizzadeh can perform a series of tests to assess his patient’s symptoms. Dr. Azizzadeh may recommend a non-surgical or surgical treatment to help his patient mitigate these symptoms.

How Is Bell's Palsy Treated?

Oftentimes, Bell’s palsy symptoms subside without treatment. If these symptoms linger for an extended period of time, high-dose steroids (prednisone) and antiviral medications (Famvir or Valtrex) may be used to treat them. In severe Bell’s palsy case, surgery may be required.

What Is Synkinesis?

Synkinesis is a facial nerve condition that causes “simultaneous movement” in the face. It affects the facial nerve function and occurs after a person experiences Bell’s palsy or other instances in which the facial nerve has been cut and sewn back together.

 

For example, after the facial nerve has been resewn, facial nerve fibers sometimes reconnect to the incorrect nerve group. In this scenario, an individual may experience synkinesis that causes unwanted and simultaneous facial muscle movements.

There are many warning signs associated with synkinesis, including:

    • Eyes narrow when a person smiles
    • Cheeks elevate when a person closes his or her eyes
    • Neck muscles tighten when a person attempts to whistle
    • Cheeks and chin twitch
    • Facial muscles tighten and cause facial pain and/or headaches
    • Deep cheek crease forms on the affected side of a person’s face

How Is Synkinesis Treated?

There is no solution to prevent synkinesis, but facial nerve compression treatment options are available. For example, patients may undergo surgery to treat synkinesis. Or, in certain instances, neuromuscular retraining and Botox treatments may be used to address the symptoms.

To determine the best course of action to treat synkinesis, Dr. Azizzadeh requests a patient consultation. Dr. Azizzadeh uses the consultation to evaluate a patient and learn about his or her symptoms. He then crafts a custom treatment program to help a patient correct his or her synkinesis symptoms.

Each synkinesis treatment program is tailored to a patient. At the same time, Dr. Azizzadeh helps each synkinesis patient establish realistic treatment goals. Dr. Azizzadeh also monitors his patient’s progress throughout a synkinesis treatment to ensure this individual can accomplish his or her desired results.

Comprehensive Facial Nerve Consultation Process

A comprehensive facial nerve consultation with Dr. Azizzadeh is a unique experience. After examining a patient’s face and learning about this individual’s concerns and goals, Dr. Azizzadeh will discuss both non-invasive and surgical approaches. As a world-renowned, dual board-certified facial plastic and reconstructive surgeon, Dr. Azizzadeh customizes surgical and non-surgical treatments to address facial paralysis symptoms. As a result, his patients can reap the benefits of a symmetrical, natural-looking facial appearance, as well as make facial expressions and chew, speak, swallow, and perform other basic facial functions without any problems.

While some patients can benefit from non-invasive procedures alone, others will need surgery to reconstruct the facial nerve and restore facial function. Dr. Azizzadeh will determine which surgical options will best benefit each patient by listening to the patient’s personal cosmetic and functional goals. He also examines the patient for underlying issues and strives to identify the root cause of each patient’s facial paralysis symptoms. In many cases, the ideal facial paralysis treatment includes both surgical and non-surgical options.

As a highly specialized facial plastic and reconstructive surgeon, Dr. Azizzadeh takes plenty of time to help his patients understand their facial paralysis treatment options. He educates patients about the underlying causes of their facial paralysis, along with how each treatment option will address those particular issues. In the complex field of facial nerve reconstructive surgery, knowledge is the most important thing for a patient, and Dr. Azizzadeh’s primary goal is to teach patients everything they need to know about the facial nerve. That way, patients understand exactly what to expect from a facial paralysis treatment, and Dr. Azizzadeh and a patient can work together to help this individual achieve the best-possible treatment outcome.

 

Am I A Good Candidate for Facial Nerve?

In deciding whether to have cosmetic surgery, patients should examine many factors that extend beyond the surgery itself.

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What Is Facial Reanimation Surgery?

In treating facial paralysis, Dr. Azizzadeh takes a multi-faceted approach to fulfill multiple objectives. Dr. Azizzadeh wants to help facial paralysis patients alleviate facial paralysis symptoms and address both functional and aesthetic issues. Each step he takes is designed to achieve the following purposes:

    • Restore functional facial movement
    • Restore dynamic and symmetrical smile
    • Improve the facial appearance
    • Prevent eye-related complications

With facial paralysis surgery, Dr. Azizzadeh assembles a team of world-class otolaryngologists, ophthalmologists and physical therapists to help patients through every aspect of treatment and recovery. From beginning to end of facial paralysis surgery, patients can rest assured they are in the hands of a dynamic, integrated team of individual experts.

There are many different facial paralysis surgery options. Facial paralysis is a constantly evolving field, and Dr. Azizzadeh explores innovative approaches to help patients relieve their facial paralysis symptoms.

Here is a summary of some of the surgical procedures Dr. Azizzadeh may use to help patients address facial paralysis symptoms:

Eyebrow and Eyelid Region:

    • Gold weight placed under upper eyelid to assist eyelid closure
    • Tightening of lower eyelid
    • Brow lift to raise eyebrow position and improve eyebrow symmetry

Smile and Mid-Face:

    • Nerve transplant to restore a dynamic smile
    • Facelift to lift drooping features and improve facial symmetry
    • Subperiosteal mid-facelift to improve drooping in the mid-face
    • Creation of nasolabial fold (smile line) when it has been lost to facial paralysis
    • Nasal reconstruction to improve breathing through the nose
    • Touch-up procedures to improve general appearance

Lower Face:

    • Wedge excision of paralyzed portion of lower lip
    • Asymmetrical facelift to restore symmetry between both sides of the face
    • Rehabilitation of lip depressor muscle

Facial Reanimation Surgery Management

Dr. Azizzadeh manages facial reanimation surgery from start to finish. He ensures his patient receives comprehensive support at each stage of surgery. Dr. Azizzadeh offers recommendations, tips, and insights to help his patient manage surgery recovery as well.

The facial reanimation surgery recovery period can be tough to manage. But Dr. Azizzadeh remains accessible to his patients during this time. He conducts follow-up appointments to verify his patient’s recovery remains on track. Dr. Azizzadeh requests patients get in touch with him if they experience any complications.

Dr. Azizzadeh confirms that his patient can produce natural facial expressions as he or she recovers from facial reanimation surgery, too. As the weeks and months pass following surgery, a patient will once again have no trouble moving their facial muscles without any restrictions.

What Is Botox for Facial Paralysis?

Botox offers a non-surgical facial paralysis treatment. A facial paralysis patient can receive Botox injections into different areas of the face. These injections help relax unwanted muscle movements on the non-paralyzed side of the face. They also reduce tension in hyperactive areas of the face in patients coping with synkinesis.

Facial paralysis patients can receive Botox injections to address asymmetric facial movement as well. And in some instances, patients benefit from Botox injections performed in combination with neuromuscular retraining.

Is Botox for Facial Paralysis Safe and Effective?

Botox is one of many treatment options available to facial paralysis patients. Dr. Azizzadeh can conduct an evaluation to determine if a patient can benefit from Botox for facial paralysis.

During a patient consultation, Dr. Azizzadeh examines his patient’s facial paralysis symptoms and their severity. He also assesses his patient’s medical history.

If Dr. Azizzadeh believes Botox can help his patient alleviate their facial paralysis symptoms, he develops a personalized treatment plan. In this instance, Dr. Azizzadeh may request Botox injections at regular intervals. This is due to the fact that a Botox treatment can deliver results that last up to four months.

Dr. Azizzadeh tracks his patient’s progress over the course of a Botox treatment. If his patient needs assistance, Dr. Azizzadeh remains accessible to him or her.

What Is Neuromuscular Retraining?

Facial neuromuscular retraining involves the use of myriad exercises to improve facial muscle coordination and/or strengthen the facial muscles. It can help a facial paralysis patient regain the ability to naturally produce facial expressions.

The ideal neuromuscular retraining exercises vary based on the facial paralysis patient. Dr. Azizzadeh and a physical therapist work with a patient to develop a custom neuromuscular retraining program for him or her. The physical therapist works with a patient to administer this program. And the program may be delivered in combination with other facial paralysis treatments.

During a neuromuscular retraining program, a physical therapist teaches a facial paralysis patient how to perform different facial muscle exercises. The therapist initially works with the patient in person. Eventually, the patient is required to perform these exercises on their own.

A facial paralysis patient has a major role in the success of a neuromuscular retraining program. If a patient performs program exercises as expected, he or she is in a great position to achieve the optimal results.

Trust Your Face to an Expert

As an globally renowned facial plastic and reconstructive surgeon, Dr. Azizzadeh has been featured in major news outlets for his unrelenting expertise in this crucial field. Most notably, he was featured on Oprah for his groundbreaking facial nerve reconstruction on Mary Jo Buttafuoco, a prominent victim of a shooting. His expertise has also been featured on The Doctor Oz Show and Inside Edition, as well as in People Magazine and The New York Post.


Schedule a Facial Paralysis Treatment Consultation with Dr. Azizzadeh

Finding the right facial nerve treatment may seem virtually impossible at times. Fortunately, Dr. Azizzadeh is available to help patients discover the best ways to overcome facial paralysis symptoms.

To find out more about how Dr. Azizzadeh helps patients treat facial paralysis, please contact us online or call us today at 310-683-4085 to schedule a consultation.

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