What You Need To Know: Facial Paralysis and Rhinoplasty

Facial paralysis involves a loss of voluntary movement of the muscles and nerves in the face. If you suffer from this condition, you may not be able to move your eyebrows, lips, or other muscles on your face. Facial paralysis can affect your ability to smile and your overall appearance. If you or someone you love has this condition, the Johns Hopkins team of experts can help you restore facial muscle balance, symmetry, movement, and smile.

  • Symptoms of facial paralysis include muscle sagging on one side of the face, weakness, and inability to move the muscles on one side of the face. Paralysis is usually linked to damage to one of the skull's nerves, which controls all facial movements.
  • If you cannot blink, raise your eyebrows, smile, or express emotions with your face, you almost certainly have a facial paralysis. Lack of treatment can lead to serious eye damage, and we are also well aware that these symptoms can make you feel insecure about your physical appearance. 
  • Other symptoms of facial paralysis that you may also notice are drooling speech disorders and nasal obstruction.

  • Your facial paralysis may have been caused by an acoustic neuroma (a benign tumor better known as a vestibular schwannoma), Bell's palsy (an unexplained incident of muscle weakness or facial nerve palsy), a carotid gland tumor, or traumatic injuries.
  • If you have not been able to move one or both sides of your face since you were born, what we have is what we call congenital facial paralysis. This can affect people of any age, even children and the elderly.
  • A physical exam will help your doctor determine if you have a facial paralysis. To rule out brain or nerve tumors, stroke, and infections as possible causes of paralysis, you may have MRI and CT scans.
  • Treatments for facial paralysis vary. At Johns Hopkins, we design a treatment plan for each patient that may include one of these variants: physical therapy, injectable solution therapy, minimally invasive surgery, microsurgical techniques, and other surgical procedures.
  • The type of treatment your doctor will use to help you regain movement in your face will depend on how long you have been paralyzed and on the condition of your facial muscles, whether they have completely atrophied.

Surgical Techniques To Effectively Treat All Phases Of Facial Paralysis:

Muscle transfer: This technique involves the transfer of muscles from one part of the body to another — usually from the face, neck, or leg — toward the face. Some of the muscles and associated tendons that are frequently transferred are the temporal, digastric, and gracile (gracillis). Top rhinoplasty specialists in Miami agree that this technique is worth discussing.

The nerve graft: This technique includes the transfer of nerves from different parts of the body to the face to ensure that you can have greater movement — and even sensitivity — in the face, which will allow you to have better control of your facial muscles. These may include the masseteric nerve graft, a crossover nerve graft, and the hypoglossal nerve graft to the facial nerve.

Eyebrow and Eyelid Repair: If you have a droopy eyelid so severe that it clouds your visual field, our surgeons can relocate it to repair your eye's function and appearance. If you can't blink, or have a hard time blinking, they can insert a small platinum chain into your eyelid so you can close and protect your eye. They can also do a nerve graft to regain the eye's sensitivity, and it can be protected.

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3D Printing Allows The Reconstruction Of The Face Of A Man Victim Of Cancer

Eric Moger will not forget the day he was diagnosed with a facial tumor, the size of a tennis ball, located on his face’s left side. In the case of this type of cancer, tumor development should not be stopped only with strong chemotherapy and radiotherapy treatments. Still, plastic surgery interventions are needed to eliminate the tumor and achieve a complete cure of the patient.

 

In the case of Eric Moger, a restaurant owner in England, his facial cancer spread over his face. The surgical treatment they applied had to remove almost the left side of his face, including the cheek, jaw and left eye. The intervention, which took place four and a half years ago, caused Eric Moger to completely change his life. Losing half of his face made his entire routine and customs upset. However, the advent of 3D printing has given it its face back in a way.

 

Facial reconstruction using 3D printing

 

Getting a new face wasn’t just an aesthetic wish for Eric Moger alone. The loss of half of his face due to facial cancer had caused him to be unable to eat or normally drink, as he had to do so by using a probe directed directly into his stomach. Therefore, recovering half of his disfigured face was not only a matter of plastic surgery but also a way to improve his quality of life.

 

Using a pioneering technique, surgeons were able to reconstruct half of her face, designing a prosthesis to cover half of her face using 3D printing. For the first time, this procedure performed in the UK by surgeon Andrew Dawood has succeeded in creating a kind of ‘mirror image of Eric’s face.’

 

To do this, they carried out a study of what Eric Moger’s face could look like using scans and three-dimensional reconstruction and then designed this facial mask, using 3D printing, in hardened nylon. In the future, the ideal would be to print this type of artificial faces in silicone, which would allow a better adaptation to the individual’s face and even the prosthesis’s different coloration (adapting it to a more brown tone, for example on vacation). Thanks to this advance, Moger was able to drink and eat for the first time, something he had not done in the previous four years.

 

The nylon was 3D printed layer by layer, and placing it on Eric Moger’s face was no easy task. This facial prosthesis is attached to your face by magnets, to facilitate its placement and removal, something that English people do daily. At one time, surgeon Dawood intended to 3D print Moger’s jawbone, which would make it easier for him to eat food autonomously.

 

A new advance, without a doubt, in 3D technology has partially restored normality to this English patient. In the future, 3D printing will continue to be one of the leading tools in areas such as medicine, as we see reflected today on the face of Eric Moger. A technique that had given him the return to his routine, since, after four years, Moger will resume the wedding plans that he had planned with his partner before he was diagnosed with the tumor.

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How To Remove The Barcode On The Face

If you already have a barcode marked and general prevention measures are not enough, you will have to resort to some treatment to solve these wrinkles. The ones that we propose below are the most used:

Hyaluronic acid infiltration

A valid option to improve the barcode is the infiltration of cross-linked hyaluronic acid. It is a naturally present substance in the body, helping to hydrate and plump the skin. Over time, the hyaluronic acid in the dermis is lost, resulting in the appearance of wrinkles and loss of volume on the face. Hyaluronic acid is commonly used to correct nasolabial, mentolabial, and perioral (barcode) wrinkles and increase volume on cheekbones, chin, and lips.

It is a very safe, biocompatible, and resorbable substance. The duration of the effect varies from 6 to 12 months. The result of the treatment, which is carried out on an outpatient basis, will be instantly visible, as the injected substance fills in the wrinkles on the spot and provides hydration. It is important to carefully select the type of acid injected in this specific area since it must be of low density because the wrinkles are fine. We must fill them without producing bulges or irregularities.

Peelings

The peelings are treatments in which the outermost layers of skin removed; they are replaced by new cells so that the skin will have less renewed blemishes and imperfections, fewer wrinkles, and be smoother. Chemical products such as phenol, trichloroacetic acid, or glycolic acid are often used to perform a peel. For fine wrinkles in the barcode, a superficial or medium peel may be sufficient, which can be done on an outpatient basis in the consultation.

CO2 laser

The CO2 laser can also be used to reduce moderate or severe perioral wrinkles. The laser performs a Resurfacing, completely renewing the treated skin. The fractionated carbon dioxide laser is a very effective ablative laser, reducing the depth of wrinkles. The skin renewal process after the laser leads to collagen formation, which allows the renewal of the dermis, making the new skin smoother, healthier, and more luminous. The number of sessions to perform to achieve the expected results is variable depending on the depth of the wrinkles.

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