Complete Flaccid Paralysis

Chronically denervated faces are characterized by soft tissue atrophy and soft tissue drooping. The atrophy results principally from chronic muscle denervation and loss of muscle bulk. While it may be surprising how much of the health and vitality of the face is related to its underlying muscle volume and distribution. There are 20 different, discrete muscles innervated by the facial nerve. When this nerve input is interrupted for more than several years, these 20 muscles undergo irreversible atrophy, essentially fading away into nothingness. In addition to enabling facial expression, these muscles support the local structures in the face, including nasal position, eyelid/brow position, mouth/lip position. When atrophied, the brow dips toward the eyelids and may actually block the eye. The upper eyelid can’t close, exposing the eye to drying and exposure. The lower eyelid often droops, leading to tearing and dryness. The nose may collapse, closing off the nostril on the affected side. The lips often hang down, leading to dribbling and ineffective speech and enunciation.