Selective Denervation

Selective denervation is a surgical procedure that can improve smile, facial symmetry, synkinesis, and facial tightness in some patients with an extreme form of faulty and over-exuberant regeneration. During the procedure, all of the facial nerve branches are mapped out to see which muscles or muscle groups they control, and then the branches which innervate muscles opposing the smile and branches causing synkinesis are cut and eliminated. Selective denervation has the potential to restore a balanced and spontaneous smile in patients while relieving some of the facial tightness that affects so many patients with chronic facial palsy. At the Facial Nerve Center, we will discuss this procedure with patients and help them decide whether it is right for them.

Selective denervation is performed under general anesthesia. A facelift incision is performed on the affected side and approximately 10 facial nerve branches are identified using intraoperative nerve stimulation. The facial movement(s) associated with stimulation of each nerve branch is carefully observed, allowing the surgeon to decide which branches should be sacrificed to improve smile and facial symmetry. These branches are resected, while the nerve branches resulting in pleasing facial movement(s) are preserved. Typically, patients will be discharged the same day as surgery, with absorbable sutures that will dissolve on their own around 14-21 days post-surgery. While improvements can be seen as soon as the first day after surgery, often we will have patients work with our facial nerve therapists beginning a few weeks after surgery to optimize facial movements and symmetry..

ef9dbc2daabe30ed28f1aa65ea98e5c8.jpg
a525e30010795f41dc702a35e5433058.jpg
before.jpg
after.jpg
68708.jpg
DSC_0599.jpg
116442.jpg
DSC_0022.jpg
87306496ee9b44e36c92cb5097492a6c.jpg
565cd3c035ac20b1d286c14d65324fc3.jpg