Facial rehabilitation treatments

Facial rehabilitation provides you with a programme of advice and exercises, unique to each individual, recognising and addressing your needs throughout the course of your recovery.

Patient education

You will be taught about the facial muscles and how the face moves, to give you a better understanding of what the team is trying to achieve. You will be given practical help and advice to help you manage some of the distressing symptoms associated with the condition such as problems with eating, drinking, speaking and protecting the eye.

Therapy

Depending upon the stage of recovery, your therapy may include:

Relaxation of the facial muscles

During the early stages of facial palsy the muscles can become overactive on the normal side as they try to compensate for the lack of movement on the weak side of the face. Relaxation of the muscles on what was once the paralysed side may be required as these muscles can become tight due to a late complication of facial paralysis.

Massage

Massaging the face helps improve blood flow to the skin and the underlying facial muscles, as well as maintaining the suppleness of the face. It also helps to preserve the idea of movement which will help warm up the muscles prior to any exercise programme.

Exercises

Once there is evidence that facial nerves have started to recover and movements start to return, you will begin exercises. The quality of the movement is more important than effort and quantity. Patients are taught to look out for any unwanted movements that may occur during the later stages of recovery as these can be problematic. For example, you may find when you try to smile or are eating, you experience closure of the eye on the weak side of the face. These are referred to as synkinetic patterns of movement.

Movement control

During the early stages you may need to learn how to reduce the over activity of the facial muscles on the normal side. During the later stages of recovery, when abnormal patterns of movement may develop, you will be taught how to let go or stretch the muscles that have become tight on what was once the weak side. You will also be taught techniques to help control the unwanted synkinetic movement.

Other therapies

Surface electromyography (sEMG)

Surface electromyography is a biofeedback technique used during the early and late stages of facial rehabilitation. The sEMG electrodes are placed over the muscles to be contracted or relaxed. The results are displayed on a computer screen, thus providing you with immediate visual feedback. This helps you to identify which of your muscles are over active and which ones need to relax. It also helps to identify and learn to control any unwanted movements.

Botulinum toxin

Botulinum toxin can be used at different times during your recovery. If sEMG or mirror feedback proves ineffective at controlling unwanted movement or producing wanted movement, botulinum can be used to temporarily reduce the activity in those muscles.

This allows you time to strengthen the weak muscles which are being over powered by the hyperactivity in other muscle groups, or improve or establish movement patterns that have become difficult because of synkinesis.

Cosmetic advice

Our resident beauty therapist can explore different make up techniques with you to help improve the appearance of facial symmetry, as well as giving you tips on camouflaging any blemishes or scars.