Facial Nerve Repair and Facial Reanimation Surgery

Facial nerve repair covers operations that restore movement to a paralysed face after injury, tumour surgery, or Bell's palsy that did not recover. Options range from stitching the cut nerve, to borrowing another nerve, to transplanting a small muscle to rebuild a smile.

The aim is a symmetrical face at rest, eye closure and some voluntary smile. It does not return the face to fully normal; movement is usually weaker than the healthy side and takes many months to appear.

What Facial Nerve Repair and Facial Reanimation Surgery involves

The choice depends on how long the paralysis has lasted. If the nerve was cut recently, the two ends are joined under a microscope, or a graft from the sural nerve of the leg or the great auricular nerve bridges the gap. If the facial muscles are still alive but the nerve near the brain is lost, a donor nerve is connected instead: usually the nerve to the masseter chewing muscle, part of the hypoglossal nerve, or a cross-face graft tunnelled from the healthy side. After roughly 18 to 24 months the facial muscles waste and cannot be revived, so a strip of gracilis muscle from the inner thigh is transplanted to the cheek with its artery, vein and nerve joined under the microscope. Smaller static procedures, such as an eyelid weight or a fascia sling to the mouth corner, are often added.

Who is a good candidate for Facial Nerve Repair and Facial Reanimation Surgery?

Timing matters more than in almost any other reconstructive operation, so early assessment is worthwhile even if surgery is not yet certain.

• Facial nerve cut during trauma or tumour removal
• Bell's palsy or other paralysis with no recovery after about 6 to 12 months and supportive EMG findings
• Long-standing paralysis in someone fit for a several hour microsurgical operation
• Children with congenital facial palsy such as Moebius syndrome, in specialist hands
• Incomplete eye closure threatening the cornea

It is usually not the right choice if:

• Bell's palsy in the first months, when most people recover without surgery
• People unfit for long general anaesthesia, for whom static slings are safer
• Anyone expecting movement within weeks
• Active tumour where cancer treatment has priority

Technique options

• Direct repair or cable graft: For a cut nerve, ideally within days to a few months of injury.
• Masseteric or hypoglossal nerve transfer: For paralysis of under about 18 months where the facial muscles are still viable. The smile is triggered by biting at first.
• Cross-face nerve graft: Brings signals from the healthy side for a more spontaneous smile; often done in two stages.
• Free gracilis muscle transfer: For long-standing paralysis or congenital absence of muscle.
• Static procedures: Eyelid gold or platinum weight, brow lift, fascia slings. Give immediate symmetry at rest without movement.

What happens during your treatment

Nerve transfers take 2 to 4 hours and a free muscle transfer 6 to 8 hours, all under general anaesthesia. You stay 2 to 5 nights; after a muscle transfer the blood flow to the flap is checked every hour at first. The cheek is swollen and you are asked not to press on it or sleep on that side.

Preparing for your trip

Plan for 10 to 14 days per stage in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Wounds heal in about 2 weeks, but the result does not. Nerves regrow at about 1 millimetre a day, so first movement appears after 3 to 6 months with a masseteric transfer and 6 to 12 months with a cross-face graft. Physiotherapy with mirror or biofeedback training is essential and continues for a year or more, so you need a facial therapist at home.

• Back to everyday activity: 2 to 3 weeks
• When results show: First movement at 3 to 12 months
• How long they last: Permanent once established

Safety, risks and revision policy

Beyond general surgical risks, the main concern is that movement is weaker than hoped.

• No or weak movement if the nerve does not regrow well
• Failure of a transplanted muscle from a blocked vessel, usually in the first 3 days
• Bulkiness of the cheek after muscle transfer
• Unwanted linked movements (synkinesis)
• Numbness on the outer foot if the sural nerve is harvested
• Mild tongue weakness or chewing change after nerve transfer

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Facial Nerve Repair and Facial Reanimation Surgery in Türkiye

Clinic-Y does not publish a single price for Facial Nerve Repair and Facial Reanimation Surgery, because the honest figure depends on your case. What moves it:

• Type of operation: nerve transfer is shorter than a free muscle transfer
• Whether one or two stages are planned
• Length of stay and intensive flap monitoring
• EMG and imaging work-up beforehand
• Added static procedures such as an eyelid weight

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions