Facial paralysis occurs when the nerve, which controls the facial muscles, stops functioning or weakens. Facial paralysis has many possible causes, the most common include Bell’s palsy, stroke, previous brain surgery, infection, trauma, or a tumor. When the facial muscles around the eye become weak or paralyzed, the health of the eye may be compromised. Typical findings of facial paralysis include:

Brow drooping – Brow drooping may be corrected surgically with a brow lift.

Poor or absent blinking – If there is some blinking ability still intact, a gold or platinum weight may be surgically implanted into the upper eyelid. The weight allows for improved eye closure.

Lower eyelid laxity, ectropion, and retraction – Lower eyelid weakness may result in an eyelid that is loose, turns out, and/or rests lower on the eye (eyelid retraction and eyelid malposition). Surgery is required to tighten the eyelid and return it to a normal position. Ectropion repair or retraction repair may be required.

Incomplete eyelid closure (lagophthalmos) – When the eyelids can’t close all the way, the cornea (clear, central part of the eye) becomes dry and may develop scarring and infections, leading to blindness if not treated. Incomplete eyelid closure may be treated initially by lubricating drops and ointment. 

If the above treatments do not resolve your concerns, surgical intervention is warranted. The outside corners of the eyes may need to be sutured together to allow for closure. This procedure is called tarsorrhaphy. Dr. Kashyap performs a type of tarsorrhaphy that can stay in place indefinitely, depending on your needs. Other eyelid procedures may also be performed with tarsorrhaphy to aid eyelid closure.

Patients with facial paralysis may have some or all of these problems depending on the severity and duration of the paralysis. Dr. Kashyap will assess your condition, discuss your personal treatment plan, and help you understand what to expect after surgery.



Most patients only experience mild discomfort after treatmen tto correct Bell’s Palsy and can resume normal daily activities within a week of surgery. Tylenol is recommended to ease the discomfort, which should subside within a few days. Arnica and Bromelain are recommended to take prior as well as after surgery to minimize the bruising and swelling of the face.

Minor swelling and bruising generally resolve within one to two weeks of surgery. Cold compresses can help you through the healing period, and we may prescribe antibiotic ointment and/or eye drops.

Cold compresses can help you through the healing period, and we may prescribe antibiotic ointment and/or eye drops.

Dr. Kashyap will see you for follow-up visits and will remove your sutures seven to 10 days after your procedure. Please avoid heavy lifting and strenuous exercise for two weeks.

Dr. Kashyap will let you know when it is safe for you to resume wearing eye makeup and contact lenses, usually within one to two weeks.

If you experience dry eye after surgery, we will recommend artificial tears to keep your eyes lubricated.

Dr. Kashyap is a NYC Oculofacial Plastic Surgeon that serves patients in the Manhattan, Flatiron, Gramercy, Murray Hill, and Grand Central areas. If you are interested in medical care to correct the effects of facial paralysis, call us today at (347) 788-1841 to schedule a consultation.

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