Facial regression = time for exercises? No, Botox!!!

[NancyMc]

In recent weeks, my facial weakness (which made substantial progress by eight weeks post-op) has worsened.  Instead of not being able to close my eye, however, I am unable to open it fully.  I wake in the middle of the night with irritation, wishing I had put gel in my eye before going to bed.
I'm nine months post-op.  Would it help to begin facial exercises?

[NancyMc]

Well, I had a call from the nurse in McKenna's office saying that what can happen is synkinesis and that I should make an appointment to see a specialist in their office who might recommend Botox injections.  Really did not want to hear that.

[Debbi]

Hi Nancy-

It does sound like synkenisis.  And, botox is one of the approaches - however, you may also want to try neuro-muscular facial retraining.  I am off to Wisconsin next month to see Jackie Diels for this very thing.  My hope is to avoid botox simply because I would need to commit to a life time of injections several times a year - yuck.  I am hopeful (and Jackie is optimistic) that I can learn to retrain my hinky facial muscles to control the amount of "inappropriate" movement in my lip and eye. 

Feel free to PM me if you want more info.

Debbi

[NancyMc]

I was hoping for exercises and will push for that treatment.  Why do you have to go all the way to Wisconsin for care?  I don't think I have movement that is inappropriate, just lack of movement that is natural.  Does that still result in a diagnosis?

[Debbi]

Hi Nancy-

In response to your question about why I'm traveling all the way to Wisconsin (good question!), I have seen several other facial therapists in the last year and a half and feel that I've exhausted the limited local resources.  Jackie has the reputation of being among the best in the country in working with facial palsy patients.  She doesn't typically see anyone before a year post op which is why I didn't see her initially.  I just want to give myself the best possible chance for a good outcome - even if it means traveling to Wisconsin in the dead of winter. 

Inappropriate facial movement (synkinesis) is when you move one muscle and another one also moves - example, when I blink my right eye, the right side of my mouth pulls up and my right cheek bunches up.  Likewise, when I smile, my right eye tries to close.  This is simply a matter of the nerves healing a bit "wrong" and sending the wrong message to the muscles.  With diligent hard work, the prognosis for overcoming this is good - no cure, just control. 

If your issue is no movement, you may just need more time.  That said, it would probably be a good thing to see a facial therapist as they can give you some do's and don'ts to minimize your risk for synkinesis.  Hang in there!

Debbi