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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. Dr. Taban has written a textbook chapter entitled “Periocular rehabilitation in facial nerve palsy”, discussing various treatment options and techniques for facial paralysis.

Surgical Options For Facial Paralysis

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

Upper Eyelid Gold Weight

A small gold plate can be inserted in the upper eyelid to increase the weight of the upper eyelid and assist it in closing and blinking.

Upper Eyelid Hyaluronic Gel Injection

Temporary fillers (Restyalne, Juvederm) can be injected into the upper eyelid to increase the weight of the upper eyelid and assist in closing and blinking. Dr. Taban often uses this method to treat patients with upper eyelid hyaluronic gel injections.


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

Brow droopiness

The brow is paralytic and cannot be raised causing heavy 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 can be performed to tighten the lower eyelid.

To view additional images of facial paralysis, visit our photo gallery.

Contact Dr. Taban

If you'd like to receive further information about various treatment options that may be best suited for you, contact Dr. Taban today to schedule an initial consult. Dr. Mehryar (Ray) Taban is board certified in the field of Ophthalmology with offices in Beverly Hills and Santa Barbara.

Next, learn more about eye retraction surgery