My facial nerve injury

In the previous blog I wrote about the anatomy of the facial nerve. Here is the link in case you missed it.

Facelift and facial nerve injury

facial nerve photo

Botox or botulinum toxin injections can also lead to facial nerve paralysis in specific areas. See below.

Why do I have a droopy eyelid after botox injection

Treatment of droopy brows and eyelids after botox

Effects of facial nerve injury

Facial nerve injury has many causes, including:

  1. Trauma – getting the facial skin cut
  2. Surgery – facelift surgery or skin cancer surgery
  3. Tumors – brain or Parotid gland tumors or cysts putting pressure on a nerve
  4. TMJ – tempro-mandibular joint inflammation
  5. Bell’s palsy – unknown cause for loss of facial nerve function

Why a sudden interest in facelift nerve injuries?

Well, I just woke up with an acute partial facial nerve paralysis. It happens relatively commonly, and in most cases has an unknown cause called Bell’s palsy. In my case, I think it may be due to a TMJ problem that causes swelling around the facial nerve and decreases its function.

Damage to facial nerve functions and results respectively lead to:
  • Chorda tympani – inability to taste with one side of the tongue

  – Decrease in amount of saliva production leads to dry mouth

  • Temporal – inability to wrinkle brow; brow will droop
  • Zygomatic – inability to tightly close eye; eye will tear up

     – Unable to blink reflexively

  • Buccal – inability to puff out cheeks and purse lips
  • Marginal mandibular – inability to show lower teeth

Symptoms of facial nerve injury?

  • Inability to close my right eye and tearing

I have patched my eye to prevent damage to my cornea

  • Unable to chew or drink properly

Just like when you have come back from the dentist after anesthesia, I cannot purse my lips and drinking from a cup; it is… messy.

  • Unable to smile

I look grumpy and when I do try to smile I look like a pirate

  • Mouth feels dry

Only some of my salivary glands are working

  • Lack of taste

Perhaps the most interesting of the symptoms is an almost total lack of taste on one side of the tongue. Technically, it’s the front two thirds that have no sensation, but it feels like the whole side. Of course, the ability to sense a bitter taste is intact in the whole tongue.

Surprisingly I can feel all foods. All food feels alike, from a piece of bread to salami to an olive. They all feel slimy like an oyster! None have any taste at all! This is the worst sensation of all, in my opinion, since I have long suffered from the vice of gluttony, which I am now denied.

Since I am someone who usually has a very animated face and uses many facial expressions when talking, the lack of muscle function on one side is even more noticeable.

Treatment of facial nerve trauma (nerve palsy)

If the facial nerve is damaged during facelift surgery, it should be repaired immediately by the cosmetic plastic surgeon.

Facelift surgery that has damaged a facial nerve but is discovered later may need complicated cross-face nerve grafts in the future.

If palsy is due to known causes like tumors or cancers, these causes must obviously be addressed and treated first.

Facial nerve injury due to other causes requires treatment with steroids to decrease the swelling around the nerve, exercises to keep the muscles of the face working and taught and… a lot of prayer.

Facial nerve palsy usually improves within three weeks to six months, but some may be left with a remnant decrease in function.

Morad Tavallali, M.D., FACS