Botox for Facial Paralysis Dallas
It is well-known that Botox can be used to treat wrinkles but it is less well-known that Botox can be used to manage an individual with facial paralysis, both temporary and permanent in nature. Facial paralysis can arise for many reasons: previous trauma, cancers like parotid tumors, acoustic neuromas, facial nerve tumors, etc., Bell’s palsy, previous surgery, or other neurologic conditions. Dr. Lam has a deep understanding of facial nerve and facial anatomy to provide the most sophisticated treatment for the individual with facial nerve paralysis. He has many patients who fly in or drive in from long distances for his expert handling of facial-nerve issues using Botox.
There can be many goals when using Botox to treat facial-nerve paralysis. Interestingly, almost always Dr. Lam is injecting the “good side” with normal nerve function in order to reduce the motion on that side to better match the paralytic side. For example, when someone smiles, the good side will pull upward and the paralyzed side will not. Accordingly, by injecting a muscle known as the levator alaeque nasi (LAN) and occasionally also the orbicularis oris (OO) on the non-paralytic side, Dr. Lam can balance the two sides so that there is less of a disparity, making someone more socially normalized and acceptable when viewed.
At times, Dr. Lam will inject the “bad side”, i.e., the paralyzed side. The reason for this is a condition known as “synkinesis”. When someone moves on the partially paralyzed side, multiple branches of the facial nerve can pull at once making the individual look abnormal. For example, when one smiles, the eyelid may simultaneously blink or contract. It is important to visually determine where the problem is and to gauge how to soften the mass movement by targeting the muscle so that excessive, simultaneous movement is reduced.
Another element to designing the treatment tailored to a particular patient is to evaluate the non-dynamic, or static, face, i.e., the face when it is not moving. When a face is paralyzed, sometimes the lack of tonicity on that side can cause the face to sag over time. Dr. Lam then targets counterpulling muscles to elevate the face on that side. Or, at times, he will inject the good side to lower the over active muscle to balance it with the paralyzed side. For example, the depressor angulae oris (DAO) can be injected to raise the corner of the mouth but it can only be undertaken if the opposing muscle, the orbicularis oris, has some upward tone.
Furthermore, it is important not only to have a detailed map or guide for current treatment but also a plan that accommodates the developing facial changes that arise over the long run. Dr. Lam refers back to previous treatment strategies but always reassesses the situation because muscle tone and facial shape do change over time. In fact, he believes that Botox for the paralyzed patient is critical not only to provide a short-term benefit but also to guide the overall shape and tone of the face in the long run so as to provide improved long-term outcomes for individuals who suffer from facial paralysis.
The complexity of Botox treatment for facial nerve patients is very high and requires a skillful eye, a knowledgeable mind, and a gentle touch. Dr. Lam provides all three. Although Dr. Lam does not accept insurance for this treatments, he does offer the most superlative care that is predicated upon a deep understanding of facial anatomy matched with an artistic eye toward facial shaping and balance.
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For a consultation with Dr. Lam regarding whether Botox for facial paralysis would work for you, please email us at [email protected] or call 972-312-8188.