Bell's Palsty

What you should know about Bell’s Palsy?

Bell's palsy is the most common cause of facial palsy, which occurs due to dysfunction of the facial nerve, leading to weakness or loss of facial movement. The abnormal facial movement can impact patients' everyday activities, including eating, speaking, smiling, and blinking or closing the eyes. Therefore, facial palsy can have profound social, emotional, and functional consequences for patients.

Even though Bell's palsy is the most common cause of facial palsy, it should only be diagnosed after other potential causes have been ruled out. Other potential causes of facial palsy include stroke, Lyme disease, Ramsay Hunt syndrome, brain tumor, head and neck tumor, trauma, surgery, and congenital abnormalities.

What are the symptoms of facial palsy?

Symptoms of facial palsy include:

  • Facial asymmetry
  • Facial muscle weakness
  • Difficulty closing eyes
  • Abnormal blinking
  • Difficulty making facial expressions
  • Changes in saliva and tear production
  • Changes in taste on the affected side of mouth
  • Sound sensitivity

How is facial palsy treated?

Patients with facial palsy should receive integrated care from a team of experts which usually includes facial plastic surgeons, oculofacial plastic surgeons, ophthalmologists, occupational therapists, but may also include optometrists, neurologists, otologists, and skull base surgeons.

Some patients with chronic facial palsy may be treated with procedures to restore facial movements and symmetry. These procedures may include free tissue transfer, nerve transfer, muscle transfer, and nerve grafting.  Static surgical procedures are also available to improve symmetry and function of the eyelid, brow, lip, and face.

How can I protect my eyes if I have facial palsy?

Facial palsy can weaken eyelid closure and blink. This often results in corneal dryness, but can also cause corneal scratches, or, in severe cases, even vision loss.

Every patient with facial palsy involving their eyelids should seek care from an ophthalmologist to receive a baseline eye exam. This helps determine the impact of facial palsy on the health of the eye. An oculofacial plastic surgeon is also often involved to assess the impact of facial palsy on the eyelids and develop an individualized treatment plan for patients to improve the function and position of the eyelids.

While waiting for a clinic visit, patients should use preservative-free artificial tears at least 4-6 times a day, and preservative-free artificial tear ointment while sleeping.

In this review article and this study, co-authored by Dr. Shannon S. Joseph, you can find a comprehensive summary of the impact of facial palsy on the health of the eye, and the management options available for patients with facial palsy affecting the eye.

Schedule a consultation

If you are have been diagnosed with Bell's palsy or facial palsy, please contact us to schedule a personal consultation with Dr. Shannon S. Joseph. She founded and was co-director of the Michigan Medicine Multidisciplinary Facial Nerve Clinic while on faculty at the University of Michigan and has extensive experience taking care of patients with facial palsy. She will perform a comprehensive evaluation and work with you to develop an individualized management plan that is tailored to you.

Learn About the Best Ways to Look Less Sleepy

Best Ways to Look Less Tired

People frequently tell us that they want to look less tired – that the appearance of their eyes makes others think that they are tired or sad or even angry. There is actually scientific evidence that the eyes are one of the first things that people look at, and also spend the most amount of time looking at, when meeting and/or talking with you. Unfortunately aging can negativity impact how our eyes look, which can in turn affect our social interactions. There are a number of changes we see around the eyes with aging:

  1. Upper eyelid skin drooping
  2. Eyebrow drooping
  3. Lower eyelid bag
  4. Darkening from a sunken area under the eyes or lower eyelid dark circles
  5. Wrinkles near the corners of the eyes
  6. Wrinkles between the eyebrows

What are the best ways to make your eyes look less tired?

Fortunately, there are many options to help reverse these changes and get you feeling and looking your best. Both surgical and nonsurgical options can be highly effective depending on your anatomy and goals.

Early crow’s feet and H-wrinkles between the eyebrows respond well to Botox injections, which are simple treatments that can be done without any downtime. There is some suggestion that these medications may even prevent formation or worsening of wrinkles. In appropriate patients, additional office-based skin treatments may also be considered, such as chemical or laser peels. These have a little more down time, but most patients are back to their usual social activities after a week.

Early lower eyelid bags may often be improved without surgery through use of dermal fillers, which lessen the tear trough deformity and give a more youthful and refreshed appearance. Within this area, fillers may last for one year or even longer. Instead of dermal fillers, some patients may wish to use their own fat from elsewhere on their body to treat the tear trough through fat grafting. More pronounced lower eyelid bags do often require surgery to achieve the best results, but this can be done with with an outpatient procedure called a lower eyelid blepharoplasty. For patients with droopy eyebrows, a brow lift helps to open the eye and gives a more youthful appearance. Finally, upper eyelid blepharoplasty is perhaps one of the most rejuvenating procedures around the eyes, and can restore a natural youthful appearance to the eyes with a minimally invasive surgery.

Schedule a Consultation

The anatomy of the eyelids and surrounding areas is complex. It is important for your eye surgery to be performed by a surgeon who specializes in plastic surgeries of the eyes and face.  Dr. Shannon S. Joseph is a fellowship-trained oculofacial plastic surgeon with extensive experience in eyelid surgery.  She is also a board-certified ophthalmologist with keen understanding of the health of the eye and vision. Learn more about why patients choose us. Our practice serves patients in Southeastern Michigan with many patients who are from Troy, Birmingham, Bloomfield Hills, West Bloomfield, Rochester, and the Rochester Hills areas.  To learn more about whether this procedure would be appropriate for you, contact us to schedule a consultation.