Selective Neurectomy

Overview

Selective neurectomy, or selective denervation, is a surgical procedure that can improve smile, facial symmetry, synkinesis and facial tightness in some patients with an extreme form of faulty and over-exorbitant regeneration. During the procedure, all of the facial nerve branches are mapped out to see which muscles or muscle groups they control, and then the branches which innervate muscles opposing the smile and branches causing synkinesis are cut and eliminated. Selective neurectomy has the potential to restore a balanced and spontaneous smile in patients while relieving some of the facial tightness that affects so many patients with chronic facial palsy.

What to Expect

At the Facial Nerve Center, we will discuss this procedure with patients and help them decide whether it is right for them.

Selective neurectomy is performed under general anesthesia. A facelift incision is performed on the affected side and approximately 10 facial nerve branches are identified using intraoperative nerve stimulation. The facial movement(s) associated with stimulation of each nerve branch is carefully observed, allowing the surgeon to decide which branches should be sacrificed to improve smile and facial symmetry. These branches are resected, while the nerve branches resulting in pleasing facial movement(s) are preserved.

Typically, patients will be discharged the same day as surgery, with absorbable sutures that will dissolve on their own around 14 to 21 days post-surgery. While improvements can be seen as soon as the first day after surgery, we will often have patients work with our facial nerve therapists beginning a few weeks after surgery to optimize facial movements and symmetry.

Our Team

The Facial Nerve Center is staffed by surgeons, physical therapists, physician assistants and other medical specialists skilled in the evaluation and treatment of facial paralysis. Our team includes Kerry Shanley Camp, PA-C, Madeline Macaluso, FNP-BC, Julia Mellon, NP-C, and Mara Robinson, PT, MS. This combination of medical expertise allows us to help patients improve their appearance, facial function, non-verbal communication and overall well-being.