ANA Discussion Forum
Post-Treatment => Facial Issues => Topic started by: kristinaarmstrong on November 17, 2015, 05:32:59 pm
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Hello. I have had 2 brain surgerys (tumor debulking), my most recent where they had to severe my 7th and 9th nerves permanently. I saw a plastic surgeon last week, he does not specialize in facial plastic surgery. I unfortunately was not impressed with his knowledge of surgery to improve the function of my face. I am guessing there is a huge difference in having a facial plastic surgeon vs a plastic surgeon. I have looked online extensively, I haven't had any luck finding a FACIAL plastic surgeon near me. Any help would be so appreciated. Thank you
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I would think you want a dr that has experience with reconstruction for facial nerve paralysis not just a general plastic surgeon. This is not just cosmetic. I saw a neuro opthamologist for my eye but ended up not needing surgery so far (8 months post op). I would be very careful who you choose so you get good results from the get go. Watch a few episodes of botched!
Also try a search for surgeons that do facial paralysis reanimation or treat facial or bell's palsy.
some info http://www.facialparalysisinstitute.com/?gclid=CIP13Niim8kCFRSEfgodaFEAwQ
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Hi and welcome,
Have you talked to your neurosurgeon from AN surgery? Did he/she mention the 12/7 nerve graft? Did the Dr offer any solution for your paralysis?
I had my facial (7th) nerve severed during AN surgery and had the 12/7 graft performed 4 days later before leaving hospital. That was in 2011 and I have had wonderful results. I would think you will need a neurosurgeon to preform the surgery as opposed to facial plastic surgeon. It's not cosmetic,, you have to have nerves grafted together in order to get function back to muscles in face. I'm not a Dr mind you,, just speaking from experience.
Good luck,, hope this helps get you in right direction. If you provide more info,, like where you are looking for a Dr.,, you may get more info.
Jane
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Dr. Patrick Byrne at Johns Hopkins is phenomenal! I had the T3 surgery 2007 & was so happy with the results. He'll let you know what he can do for your situation. I have total facial paralysis - the idiot surgeon I went to decided to cut my facial nerve even though the tumor lifted easlity off the facial nerve... I suggest you contact Dr. Byrne - he is amazing!
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Hi.. I would recommend Solomon Facial Plastic in Toronto ( http://www.solomonfacialplastic.com/cosmetic-plastic-surgery-toronto.php ).
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I had my seventh nerve severed during my AN surgery. I had a surel cross facial nerve graft and trigeminal nerve graft. My main surgery was on 3/31/2015 and nerve grafts started two weeks after. The facial reconstruction was done at John Hopkins by Dr. Kofi Boahene. Amazing Doctor.
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When or is it ever to late for a nerve graft? I am 22 months post my an surgery. Will the nerve graft help with the one sided droop at my mouth?
Feline
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You right. Time is a factor. With time and lack of use, muscles experience atrophy, and makes a nerve graft less likely to succeed. This is why when a patient has a facial nerve resection during surgery, facial reconstruction can start immediately. I'm not sure on the time duration, but I would expect 22 months to be too long. Keep in mind, my nerve grafts were started within a couple weeks of my main AN surgery, and they were ALL outpatient surgeries (of course my 17 hour AN surgery was inpatient).
You do have options if you are 22 months with complete facial paralysis. For example, instead of a simple nerve graft, they will need to also transplant muscle from the leg.
Talk to a Facial Plastic Surgeon with experience on facial paralysis. As you know, we are a rare group. Dr. Kofi Boahene at John Hopkins is a amazing.
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Yes, true thank you for ur input but my at surgeon at Stanford recommended I waited till I was 18 months or so to have a nerve graft done
Feline
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I also had the 12/7 nerve graft preformed. Mine was done 4 days after my AN surgery while I was still in the hospital. I was told that it is best to have the graft done ASAP while nerve endings were still "alive" and viable and, as Caryawilson says, the muscles don't atrophy making movement and success of graft more likely.
I'm also not sure how long would be too long to wait. I would think 18 mos would be a long time based on what I was told. But I'm not a doctor,,,
Yes, you can also have a muscle graft. One I was told about is called a Gracilis Free Flap surgery. Basically, ( from what I remember being told) it is not a nerve graft but a muscle ( usually from the thigh I believe) graft. A muscle is transplanted to cheek area and attached to a muscle and you can get a better smile with it. Now this may only be possible with the nerve graft, I'm not sure. The doctor I was told about who is expert at it is Dr Tessa Hadcock at Harvard or Mass. Ear and Eye clinic,, you can "Google" her.
There is also the T-3 surgery that uses a tendon, I believe, from temple area. Not sure about specifics.
Good luck. Maybe your neurosurgeon can recommend something since he told you to wait,,,
Jane