Facial Nerve Transfer Surgery

Facial nerve transfer surgery can restore movement to your face after recent facial paralysis if your facial muscles are still healthy. This procedure works best when you’ve had paralysis for less than two years and your face muscles have not weakened permanently.

The goal of nerve transfer surgery is to reconnect a working nerve to the paralyzed facial nerve so your facial muscles can move again.

At UVA Health, we use several nerve transfer techniques depending on the cause and timing of your paralysis.

How Facial Nerve Transfer Works

During nerve transfer surgery, we connect a nearby healthy nerve to your paralyzed facial nerve. This allows the healthy nerve to send signals that activate the paralyzed facial muscles.

One commonly used nerve is the masseter nerve, which controls a chewing muscle in front of your ear. When connected to the facial nerve branch used for smiling, it can help you lift the corner of your mouth again.

After surgery, your smile may appear when you clench your teeth. With time and physical therapy training, many people learn to smile more naturally and easily.

Another option uses part of the hypoglossal nerve, which controls the tongue. Connecting this nerve to the facial nerve can help minimize drooping and improve facial movement. With practice and therapy, you can retrain your facial muscles to move more naturally.

Cross-Facial Nerve Grafting

In some cases, we connect nerves from the healthy side of your face to the paralyzed side. This technique uses a nerve graft to carry signals across the face.

We often use the sural nerve, which is near the ankle. We tunnel the nerve graft under the skin across your face. Signals from the healthy facial nerve activate muscles on the paralyzed side.

Cross-facial nerve grafting may allow the paralyzed side of the face to move automatically when the opposite side moves.

Choosing the Right Nerve Transfer

The best option for you depends on how long you’ve had paralysis and which nerves are still healthy.

In some cases, we combine more than one technique to achieve the best result. We’ll carefully evaluate your facial nerve function and build the best care plan for your specific situation.

Recovery After Nerve Transfer Surgery

Nerve transfer surgery restores the pathway for nerve signals, but the nerves need time to grow and reconnect with facial muscles.

Most people begin to see movement several months after surgery. Results can continue to get better for more than one year after surgery.