If you’re still feeling tightness on one side of your face, your eye narrows when you smile, or your neck pulls when you move your mouth after Bell’s palsy, facial synkinesis could be the reason. During recovery, facial nerve fibers can start activating muscles together that should move on their own.
At his Upper East Side practice, Joshua D. Rosenberg, M.D., looks at persistent Bell’s palsy symptoms to find out if weakness, synkinesis, muscle overactivity, or an eye-closing issue is making movement harder for you.
Why Can Symptoms Continue After Bell’s Palsy?
The National Institute of Neurological Disorders and Stroke explains that most people recover facial function within a few weeks to six months, although some continue to have weakness, involuntary movements, or other lasting effects.
If you notice a new facial droop or sudden changes, it’s important to get medical attention right away since other conditions can look similar. Once your recovery has leveled off but you’re still seeing linked movements, a facial paralysis evaluation can help pinpoint which muscles and nerves are involved.
What Does Facial Synkinesis Feel Like?
Facial synkinesis causes an intended movement in one part of your face to trigger an unwanted movement elsewhere. Signs may include:
- Your eye narrows or closes when you smile
- Your chin dimples when you move your mouth
- Your cheek or neck tightens during facial movement
- One side of your mouth pulls downward
- Spasms interfere with eating, speaking, or expression
The muscles behind these patterns can be different for everyone. Planning your treatment starts by watching how your face moves at rest, when you blink, smile, speak, and during other expressions.
Which Treatments May Help Facial Synkinesis?
Treatment should match your movement pattern rather than chase a single visible symptom. A systematic review in Frontiers in Neurology supports facial neuromuscular retraining as a first-line treatment, followed by targeted botulinum toxin. Surgery may be considered for selected patients whose symptoms remain troublesome.
At Dr. Rosenberg’s practice, facial synkinesis treatment can include selective neurolysis, muscle transfer, facial slings, or eyelid surgery for certain patients. Selective neurolysis may help if overactive muscles and nerve branches are causing tightness or pulling around your mouth.
Treatment can help improve your movement, comfort, and facial balance, but it can’t guarantee perfect symmetry or restore every muscle to how it worked before Bell’s palsy.
Why Does Facial Paralysis Experience Matter?
Persistent Bell’s palsy symptoms affect facial nerve function, muscle coordination, eye protection, and mouth function. Joshua D. Rosenberg, M.D. is a diplomate of the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. He also leads research evaluating surgical and nonsurgical treatment for facial nerve paralysis.
With this background, Dr. Rosenberg can assess how your face moves as a whole and recommend Bell’s palsy treatment in NYC that fits your needs.
FAQ
Can facial synkinesis improve years after Bell’s palsy?
You may still see improvement in long-standing symptoms with treatment, but your options depend on your movement pattern, any previous treatment, and how your nerves and muscles are working now.
Is an uneven smile always caused by facial synkinesis?
No. Residual weakness, muscle tightness, nerve injury, or another condition could be affecting your smile. You’ll need an exam to find out what’s causing it.
Explore Bell’s Palsy Treatment in NYC
If an uneven smile after Bell’s palsy, ongoing tightness, or eye narrowing is making it harder to eat, speak, blink, or express yourself, schedule a consultation with Joshua D. Rosenberg, M.D. We’ll look at your facial movement and walk you through the nonsurgical or surgical options that could work for you.
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