Can I Get Eyelid Surgery After Facial Nerve Issues?

Facial nerve palsy

Hello, about five years ago, I experienced symptoms of facial nerve palsy on the right side of my face.
However, it recovered in about a month.
Now, when I close my right eye, the corner of my mouth gets pulled, and when I pucker my lips, the right eye bag also moves slightly.
But if I don't actively mention it, it's not very noticeable! Recently, I am considering getting double eyelid surgery with sutures and would like to know if it is safe to undergo the procedure.
Will there be any complications?

jenny, 20~29 year old female. Ask Date: 2015/08/24

Dr. Lan Shengxing reply Neurology

Dear Jenny, this type of synergistic effect often occurs after nerve damage, where the newly regenerated nerves branch from a remaining nerve that originally innervated a small area of movement.
Now, it has changed to innervate a larger area of movement, which can lead to unintended activation of other regions during fine motor tasks.
Generally, if there is no involvement of the muscles, this phenomenon is less likely to be affected.
However, I recommend that you discuss your concerns with the surgeon so that they can choose the appropriate surgical technique.
Best regards, Blue Saint Star.

Reply Date: 2015/08/24

More Info

When considering eyelid surgery, particularly after experiencing facial nerve issues, there are several important factors to take into account. Your history of facial nerve dysfunction, even if it has resolved, may influence both the surgical procedure and the outcomes.

Firstly, it is essential to understand the nature of your previous facial nerve issues. If you experienced temporary facial nerve paralysis, such as in cases of Bell's palsy or other similar conditions, and have since fully recovered, you may be a candidate for eyelid surgery. However, the fact that you still notice some movement in your mouth when closing your right eye suggests that there may still be some residual nerve involvement. This could potentially complicate the surgery or the recovery process.

Eyelid surgery, or blepharoplasty, involves altering the skin and muscle around the eyelids. If there is any residual weakness or abnormal movement in the facial muscles, it could affect how the eyelids heal and function post-surgery. For instance, if the muscles controlling eyelid closure are not functioning optimally, this could lead to complications such as incomplete eyelid closure, which can result in dry eyes or exposure keratitis.

Moreover, the surgical technique used can also be a factor. If you are considering a specific technique, such as the use of sutures (as in your mention of "訂書針"), it is crucial to discuss this with your surgeon. Some techniques may be more suitable for individuals with a history of facial nerve issues than others. Your surgeon will need to assess the strength and coordination of your eyelid muscles and facial muscles to determine the best approach.

It is also important to consider the potential for scarring and how your body heals. Individuals with prior nerve damage may experience different healing responses, which could affect the aesthetic outcome of the surgery. Scarring can also impact the function of the eyelids, especially if the incision is made in a way that affects the surrounding muscles.

Before proceeding with surgery, a thorough evaluation by a qualified plastic surgeon or oculoplastic surgeon is essential. They will likely perform a physical examination, assess your facial symmetry, and evaluate the functionality of your eyelids and facial muscles. They may also recommend imaging studies if there are concerns about underlying nerve or muscle issues.

In summary, while it is possible to undergo eyelid surgery after experiencing facial nerve issues, careful consideration and evaluation are necessary. Discuss your concerns and medical history in detail with your surgeon, who can provide personalized advice based on your specific situation. They will help you weigh the risks and benefits, ensuring that you make an informed decision about your surgical options. Additionally, they may suggest alternative treatments or therapies to optimize your facial muscle function before considering surgery.

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