Facial paralysis and reanimation

"Smile surgery"

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For patients who have permanent weakness or paralysis of the muscles that are used in facial expression, Duke’s surgeons and other specialists work together to restore facial expression, especially the ability to smile.

Specialists from plastic surgery, speech therapy, and physical therapy provide a coordinated effort to patients, many of whom travel from a distance to receive the comprehensive care offered at Duke.


A child with congenital facial paralysis is born with complete paralysis of muscles of facial expression on one or both sides. This extremely rare condition can now be treated with high expectations.

Such paralysis can occur alone or as part of a syndrome such as Moebius Syndrome. Whatever the cause, Duke’s program can help.


In adults, partial or total paralysis can be caused by infections such as Bell’s palsy, local growths and tumors on the face, tumors within or adjacent to the brain such as an acoustic neuroma, or injury to the facial nerve or to the facial muscles themselves.


Duke’s surgeons have experience and success in surgery to help create a symmetrical smile and improve speech.

One nerve controls the muscles of the mouth, forehead, eyelids, and nose. When this nerve is damaged, all aspects of the facial expression, including the smile, are affected.

Surgery can restore the ability to smile and also support those other muscles, to improve facial expression.

The surgery may involve nerve grafts as well as transferring living muscle tissue from elsewhere in the body.