Frequently Asked Questions about

FACIAL REANIMATION SURGERY

What type of surgery did you have for your facial paralysis?

I actually have had three different surgeries. 

1.  In February 2011, I had Facial Reanimation (aka smile surgery) to restore function and some mobility to my face.  I had the one part free muscle transfer.  This is where they take part of the gracilis muscle from the thigh and transplant it into the face. The nerve is attached to the masseter (chewing) muscle.  At first, I had to bite down to trigger the muscles to work and make my face smile.  Now, 7 years later, I can smile without biting down. 

2.  In February 2012, I had a mini brow lift to relieve some of the droopiness from my eye. 

3.  In May 2016, I had Blepharoplasty (eyelid surgery).  They removed a section of my eyelid to further assist with the droopiness.  My eye still droops some or looks kind of like a lazy eye especially on days that I'm very tired or not feeling good.  But any relief was good relief in my eyes (pun intended). 

All three surgeries were done at Duke University Medical Center and Duke Aesthetic Center in Durham, NC.

Are you crazy?  Why would you have something as crazy sounding as facial reanimation surgery?
I looked at this surgery like I did any other surgery I might need on any other part of my body.  I had limited function and use.  If it were my arm or my leg and I was offered a surgery that would help regain some mobility and function, I would have surgery on that.  So why not my face?  I did go into this surgery with an open mind and a very good understanding that it might not work and if it did, I still might not have full function and mobility of my face.   I knew this was not a miracle cure all for my paralysis.   I have been asked didn't I think this was a little vain on my part doing this since it was my face.  No, not at all.  Yes, I missed having my pretty smile but I also missed being able to use my mouth and face like before.  I did what I felt was needed and the best option for me.   

Was it a hard decision to make?  Did it not terrify you to decide to have such an extreme surgery?
This surgery brought out a full range of emotions.   I was excited.  I was scared.  I was uncertain.  I asked everyone else what they thought and I got an array of answers.   I found out sometime around August 2010 that I qualified.  And I believe it was Novembmer 2010 before I picked up the phone to call my surgeons to get the surgery scheduled.  Making that decision was one of the most taxing things I've ever done.  But I had a huge support system from friends and family and so many prayers it was ridiculous.   The morning of my surgery, I hit my knees in my hotel room, cried and told God "I'm giving it over to you" and I let any fear and uncertainty go.   y pastor and my nursing staff said they had never seen anyone so calm and laughing go into a major surgery like this before.  When I said I gave it to God...I GAVE IT TO GOD! 

How long was the surgery?
The facial reanimation was a 6 hour surgery.  They started at 7 a.m. and finished at 1 p.m.  I was in recovery until 5 p.m. before I got moved to my room.   The mini brow lift took somewhere between one and two hours.  I was in recovery for about a couple of hours and went home that same day.   The Blepharoplasty was done outpatient in my eye surgeon's office and took less than an hour.   

How long was your hospital stay for the facial reanimation surgery?
5 days. I was admitted on Monday around 530 a.m. and had surgery that same day.  I spent that night and the following days in the trauma unit at Duke University Medical Center and was discharged home on that following Friday.  

Which surgeons and medical facility did you use?

Okay, let me preface this with when it comes to medical care, I will research the heck out of a doctor and facility.  So I knew going into this that I wanted the best and nothing short of that.  So with that, I had two of the most amazing surgeons in all the land!  Dr. Michael Zenn and Dr. Jeffrey Marcus.  Their information can be found on the links and resources page.  Dr. Zenn is in Raleigh and Dr. Marcus is in Durham, NC.  My pre and post surgical appointments were always either at the Duke Aesthetic Center or at Duke University Medical Center clinics.   My hospital stay was at Duke University Medical Center.  And when I say I had the best of the best of the best top  notch care, that doesn't even begin to explain the care I received.   Both my physicians have wonderful bedside manners and were so amazing during everything.  I am still in contact with Dr. Zenn and his nurse, JoAnn, who were my post-op medical peeps.  I simply can't say enough good about them.  And my nursing staff at Duke were pure God sent angels!  So sweet and precious.  Dr. Zenn also performed my mini brow lift.   Dr. Julie Woodward (Oculofacial Plastic Surgeon and an Ophthalmologist ) did my eyelid surgery.

Was it painful?
I had a morphine drip for the duration of my stay at the hospital and was sent home with pain medication.  I don't remember a great deal of pain and I don't like to take pain killers if I don't have to.  I think I only took them a couple of days and started only using Ibuprofen.   The hospitals are well equipped and very good at pain management during the stay.  I did get an infection 3 weeks after my surgery and that was painful.  I did have to have the incision drained and a nurse came to my house daily to change my packing in the incision.  That required pain medication but only for a few days.  

How long was your face swollen?
Months.  I'm not going to sugar coat it.  The swelling is a pain in the booty.  It does gradually decrease each week but I don't want anyone going into this thinking you won't have swelling for a long time.  You will.    My face was swollen for months.  The mini brow lift was not as bad.  I still had swelling and bruising but it was gone within a couple off weeks max.  Same for my eyelid surgery.

Is your face bulky because you have a thigh muscle in it?

This always makes me laugh when people ask me this.  And they usually ask me while looking straight at my face.  At first, I had a huge chipmunk cheek.  Looked like I was hoarding a stash of nuts for the winter.  It did take several months for the swelling to go down.  But now, you can't really tell any difference from my other cheek/jaw.   I will add this.  I do have very strong thigh muscles.  My surgeon was very impressed how strong they were.  To the point, he said they had to keep shaving the muscle down for it to fit.  Not fat...thick strong muscles.   I can kick like a horse people.  So with that said, I do have a very strong bite.  So don't make me bite you...I'm like a pitbull...not letting go!  lol 


Did the surgery fix your facial paralysis?

What I want everyone to understand is that the purpose of the surgery is to help "improve" and "regain function".  It is not a miracle cure for paralysis.  There is currently not a cure for paralysis and nothing that I am aware of to completely fix our face.   It took me awhile to accept that my face would never be as it was before.  I might have a new smile but it was not going to be the same smile.  I can't eat and drink like everyone else.  I had lost my ability to do small things like whistle (I have recently this year in 2018 learned how to do this again).   My eye has a mind of its own most days.  And I am okay with it all.  It does not define who I am.  

Do you have scars?
I sure do.   I have a scar on my inner thigh that is about 6 inches long where they removed the gracilis muscle.  It is not visible unless I have on a bathing suit and then it still isn't real prominent.   My scar on my face runs from my temple in my hairline down my earlobe and along my jawline.   No one EVER notices.  I have to physically point it out and show them.  Then they can only see a very faint scar along my jawline.  I had amazing plastic surgeons who completed the procedures so they knew how to patch me up and leave minimal scarring.   My incisions were very red, purple and raised for a long time.  Maybe around a year or little bit longer.  But once they completely healed, they started fading over time.  

I have a scar on my scalp from the mini brow lift but you can't see it because my hair covers it.  I really have to feel around up there and search for it for me to even find it.  I do not have a scar from the eyelid surgery.  

 

Does the surgery help with the synkinesis in your eye?
No it doesn't.  Facial exercises are the best bet for synkinesis and in some cases botox can help. 

Did insurance cover the surgery?
I had Blue Cross Blue Shield at the time of my facial reanimation and mini brow lift and they paid with the exception of my deductibles.  My surgery was coded for insurance as medically necessary for loss of function and mobility, not as a cosmetic procedure.   I had Aetna for the eyelid surgery.  I only had an office copay for it since it was done at the surgeon's office and I was not put to sleep.  

 

Would you do it again?
ABSOLUTELY!!   I have not once regretted having any of this done.  Like I said earlier, you have to have a good perception of the surgeries and understand that these are NOT miracle cures.  And I knew that.  I am happy with the results and have regained a lot of function I had lost.  

Disclaimer:  I am not a medical professional.   All information above is based on my personal experience only.  This should not be substituted for any medical advice.  Please consult your physician for the best treatment options for you. 

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New Bern, NC   28562

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