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Facial Paralysis, Eyelid Paralysis & Bell’s Palsy

What is Facial Paralysis?

Facial paralysis has many causes including prior surgery, tumors, trauma, infection, and inflammatory conditions. When no known etiology is found, it is labeled Bell’s palsy. Bell’s palsy is a temporary or permanent weakness or paralysis of the facial nerve (7th nerve). The facial nerve innervates the facial muscles, which are responsible for various facial movements including eyelid closure and blinking, smiling, raising brows, frowning, among others. If the facial nerve is affected, then one is unable to close the eyelids (lagophthalmos) and the lower eyelid turns out (ectropion) unable to pump the tears normally resulting in tearing and eye redness and significant irritation (exposure keratopathy).

Treatment For Facial Paralysis

The most important treatment is frequent and aggressive ocular lubrication to protect the eye since the eyelids cannot close. The eyelids should be taped at night. Punctal plugs can also be used to reduce tear drainage. Eyelid surgeon Dr. Taban in Santa Barbara has written a textbook chapter entitled “Periocular rehabilitation in facial nerve palsy”, discussing various eye treatment options and techniques for facial paralysis.

Surgical Options For Facial Paralysis

Due to the many different options of reconstructive eye treatment for the various types of causes for face paralysis, it’s important to speak with a board certified ocular plastic surgeon in Los Angeles in order to learn more about which eye treatment option may be best for you and your specific needs.

Upper Eyelid Gold Weight

A small gold plate can be inserted in the top eye crease to increase its weight and assist it in closing and blinking.

Upper Eyelid Hyaluronic Gel Injection

Temporary fillers (Restylane, Juvederm) can be injected into the upper eye to increase the weight of the upper eye fold and assist in closing and blinking.

Read Article Published by Los Angeles’ Dr. Taban about Eyelid Facial Paralysis

Read Article Published by Los Angeles’ Dr. Taban about Upper Eyelid HA Fillers


Tarsorrhaphy is a temporary or permanent procedure that “pinches” the lateral corner of the eye, thereby making the eye smaller and allowing better closure of the eye.

Brow droopiness

The brow is paralytic and cannot be raised causing heavy top eyelid and inability to see properly. The brow can be lifted via various techniques (see section on brow lift).

Lower Eyelid Ectropion

A paralytic lower eyelid rolls out, causing eye irritation and tearing. Surgery treatment can be performed to tighten the area.

For more information on treatment for Facial Paralysis please visit

Next read about congenital/pediatric oculoplastics.

Before & After Photos

*See disclaimer below
Before (left) and 6 weeks after (right) left paralytic brow lift (note scar is healing well).
Before (left) and after (right photo) of right upper eyelid gold weight placement. Note the right eye closes completely after the procedure.
Photos, with eye open and closed, showing that the left upper eyelid gold weight is hidden nicely.
68 year old female, with paralytic left lagophthalmos (unable to close left eye) from left eyelid facial palsy, underwent left upper eyelid gold weight and left lower eyelid ectropion repair with skin graft. Before and 3 months after eyelid surgery photos are shown.
Before (left) 70+ year old male with left facial/eyelid paralysis from Bells palsy with paralytic left lower eyelid ectropion. After (right) underwent left lower eyelid ectropion surgery with skin graft.
*Disclaimer: Results vary from patient to patient. Results are not guaranteed.

I was diagnosed with Graves' Disease in 2007 ... I had 2 other surgeons prior to meeting Dr. Taban.... Dr. Taban did the orbital decompression on both of my eyes in 2010 and my eyelids retraction in 2011. ... He made me look normal again. ... I'm very grateful to Dr. Taban. He brought back my self-confidence.

Amabelle A.

Amabelle A. Location Reviewed November 2, 2016

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