“Eyelid Surgery in Facial Nerve Palsy: Restoring Symmetry Through a Specialized Approach”
The most important goal of eyelid surgery in patients with facial nerve palsy is the restoration of symmetry. Unlike standard cosmetic eyelid procedures, facial nerve palsy involves a fundamental limitation of muscle function, which means that both the surgical approach and the overall treatment plan must be completely different.
The patient shown in the photos below has left-sided (Lt) facial nerve palsy. Because the muscles on the left side are barely functioning, excessive effort is required from the normal side (the right eye) in order to open the eyes. Although the eyes may appear open at rest, many patients experience continuous discomfort due to constant unnecessary muscle tension.
While the eyes may look open externally, the act of opening them requires sustained strain, which leads to significant fatigue and discomfort. For this reason, the starting point of surgery in these patients is an accurate assessment of how much opening strength remains in the paralyzed eye.
Eyelid Surgery in Patients with Facial Nerve Palsy
Comparison before and after opening the eyes widely
As shown in the images above, when comparing wide eye opening before and after surgery, it is evident that significantly less effort is required postoperatively, resulting in a more stable and comfortable eye-opening function.
In facial nerve palsy patients, performing a simple ptosis correction on the paralyzed eye alone often has limited clinical significance. In most cases, the surgical plan involves first correcting the non-paralyzed eye to a normal functional range, followed by adjusting the paralyzed eye accordingly. However, depending on the severity of the palsy, residual muscle function, and disease course, the surgical strategy and sequence may need to be modified.
From an aesthetic standpoint, balance and harmony between both eyes are essential. Nevertheless, in clinical practice, many patients resign themselves to the eye affected by facial nerve palsy and give up on surgical correction altogether. This is precisely why it is crucial for these patients to receive an accurate diagnosis and consultation from a plastic surgeon with extensive experience in facial nerve palsy–related eyelid surgery.
Eyelid surgery is never simple. There is no fixed formula, no standardized implant materials, and the eyes are constantly moving organs that are closely connected to the brain. In cases such as facial nerve palsy caused by trauma or illness, the number of unpredictable variables increases significantly, making surgery even more challenging. Ultimately, the outcome of eyelid surgery depends largely on the surgeon’s depth of experience across a wide range of complex cases.
AHNSUNGMIN Plastic Surgery specializes in eyelid surgery, particularly revision surgery and complex cases that require both functional and aesthetic considerations. Rather than focusing solely on cosmetic improvement, the clinic prioritizes functional recovery and overall facial balance. From the initial consultation through surgery and postoperative follow-up, Dr. Ahn Sung Min personally oversees every step of the process, carefully analyzing each patient’s condition to establish the safest and most appropriate surgical plan.
Even in cases such as facial nerve palsy, which demand a high level of judgment and expertise, AHNSUNGMIN Plastic Surgery pursues stable and reliable outcomes through an individualized, experience-based approach.
Eyelid surgery is not about following trends. Only by fully understanding the patient’s current condition and proceeding with the most suitable surgical plan in the correct sequence can truly satisfactory results be achieved. AHNSUNGMIN Plastic Surgery remains committed to these principles, upholding its responsibility and expertise as a dedicated eye plastic surgery clinic.
Ahnsungmin Plastic Surgery
Ahnsungmin Plastic Surgery is a clinic specializing in complex eyelid revision surgery.
Under the expertise of Dr. Ahnsungmin, and with extensive experience in high-difficulty revision cases,
we provide patient-specific surgical plans aimed at achieving stable, natural, and long-lasting results—even in the most challenging cases.
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