Surgical Management of Synkinesis & Static Procedures for Flaccid Facial Palsy

First, Dr. Yang reviews the difference between flaccid and non-flaccid (including synkinetic) facial paralysis. She describes her approach to facial paralysis, which includes clarifying the patient’s diagnosis and thoroughly examining the facial nerve function. Dr. Yang then transitions the conversation to surgical solutions, emphasizing dual goals of restoring symmetry and function. She divides her discussion to first tackle synkinesis and then static procedures for flaccid paralysis. Procedures discussed include Botox, brow lift, blepharoplasty, myectomy, and neurectomy as well as lower eyelid and midface procedures and temporalis tendon transfer. While surgical approaches to the two conditions differ, eye protection represents an important theme throughout. The episode concludes with Dr. Yang’s pearls for approaching these complex surgical problems and a reminder of how facial paralysis affects patients’ emotional health.