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Home/Facial Procedures/Facial Palsy & Paralysis Reconstruction

Disorders of the facial nerve are extremely complex and can significantly affect quality of life. London consultant plastic surgeon William Townley is highly trained and experienced in the diagnosis and effective treatment of facial palsy and paralysis using a broad range of state-of-the art techniques. As a leading plastic surgeon in the field of facial palsy and paralysis reconstruction, Mr Townley works collaboratively with specialists in ENT, Paediatric Plastic Surgery, Ophthalmology, and Facial Physiotherapy to create customised treatment plans designed to achieve optimal results for his patients. In addition to his practice, Mr Townley also dedicates his time and professional skills to facial palsy charities and organizations committed to helping improve treatment outcomes for patients.

The facial nerve powers the muscles that are responsible for essential emotional expressions such as smiling as well as basic functions including, eating, speech, and eye closure. Facial nerve injuries can therefore be devastating, both from a functional and aesthetic viewpoint. Mr Townley offers the full spectrum of facial reanimation treatments to children and adults suffering with facial paralysis from simple chemodenervation techniques (botulinum toxin for synkinesis) to free functional muscle transfer.

“Mr Townley is excellent. He is polite professional and down to earth. Made me feel at ease from the moment I met him. Reassured me with every question I ever had and has done an amazing job on making me a new person. I’d highly recommend him to anyone.”


What is Facial Palsy & Paralysis Reconstruction?

Treatments and reconstruction procedures for facial palsy and paralysis are designed to restore function and aesthetics in patients affected by a variety of long-standing and/or recent-onset facial nerve injuries.

Who Is a Candidate for Facial Palsy & Paralysis Reconstruction?

There are many causes of facial nerve injury and patients need to be assessed on an individual basis to determine likely prognosis and best course of action. A list of common procedures performed by Mr Townley is listed below. Most procedures require diligent physiotherapy to get the best results.

What Are My Options for Facial Palsy & Paralysis Reconstruction?

Based on your diagnosis and a full medical and aesthetic evaluation, Mr Townley can design a customised treatment plan suited to addressing your specific needs with the most appropriate procedure(s).

Dynamic Procedures

Listed below are interventions that can restore movement to the affected side of the face by either powering the normal facial muscles or by harvesting the power of other muscles to do a similar job:

Free Muscle Transfer (Gracilis)

The gold standard reconstruction in patients with a long-standing facial paralysis. When powered by a nerve graft connected to the other (‘intact’) side of the face, it gives the best chance of a spontaneous and symmetric smile.

Temporalis Sliding Myoplasty

An increasingly popular technique for restoring the ability to smile. This technique requires intense physiotherapy afterwards to ‘learn’ to smile again. It may be suitable for elderly patients with long-standing facial paralysis who are looking for a simpler operation.

Nerve Transfer or Graft

This approach may be appropriate in patients who have had a recent onset of facial paralysis. It is often performed in conjunction with other procedures such as tumour removal.

Static Procedures

These are a series of interventions that can improve position of the affected side of the face as well as improve function (eye protection, oral control of solids and fluids).

Brow Lift

Facial nerve injuries may result in a droopy eyebrow appearance. A brow lift is a relatively simple procedure that can elevate the position of the brow to match the unaffected side.

Fat Grafting

Fat transfer is a relatively noninvasive procedure that can help restore contour to the face and improve function, e.g. by supporting flaccid structures such as the eyelid. Mr Townley is a pioneer and expert in fat grafting to the face.

Eyelid Protection (Oculoplastic Surgery)

Simple procedures that can often be done as an outpatient under local anaesthetic to facilitate eye closure and eyelid position. These include:

Static Sling to Cheek

A simple procedure that can improve the position of the face at rest by using a piece of fibrous sheet to tighten and lift the cheek.


Correction of Lower Lip Asymmetry

Lower lip asymmetry is one of the most common issues in patients with facial nerve weakness. There are several techniques aimed at improving symmetry and function.

Botulinum Toxin (chemodenervation)

BOTOX® may be injected into the affected side of the face to relax facial muscles that have become tight or to reduce unwanted muscle movements. It can also be used on the unaffected side of the face to improve the overall symmetry and appearance.

Why Choose Mr Townley for Facial Palsy & Paralysis Reconstruction? 

William Townley is one of the foremost consultant plastic surgeons in London performing facial palsy and paralysis reconstruction. Mr Townley is a lead clinician in the Facial Nerve Centre at Guy’s and St. Thomas’. There he runs a multidisciplinary team with specialists in Paediatric Plastic Surgery, Ophthalmology, ENT, and Facial Physiotherapy while also sitting on the Medical Advisory Board for the charity Facial Palsy UK. In addition, Mr Townley is a member of the Sir Charles Bell Society, an international organisation of experts from different specialties dedicated to improving outcomes in facial palsy.

Mr Townley has visited and trained in several international units (Los Angeles, London, Toronto, Boston, Vancouver, and Caen) to learn contemporary techniques and facilitate an innovative approach to his own practice. Due to his extensive training and experience in the field of facial palsy and paralysis reconstruction, many patients with facial nerve injuries seek his expertise to restore their facial function and aesthetics. Through his compassionate, dynamic, well-informed approach, Mr Townley earns the trust and confidence of his patients. While treatments for facial palsy and paralysis can be complex and demand the use of intricate techniques, Mr Townley draws upon his extensive resources and diverse skill-set to design customised solutions to best serve his patients’ needs.

How Much Does Facial Palsy & Paralysis Reconstruction Cost?

Since the corrective treatments and procedures for facial palsy and paralysis can vary based on each patient’s unique needs, costs for this type of care are challenging to estimate without a comprehensive consultation. To find out how much a customised treatment plan would cost, a consultation must be scheduled with Mr Townley. Following your appointment, a cost estimate will be provided based on the details of your treatment plan. Under certain circumstances, your treatment may be available on the NHS. Mr Townley’s office team is happy to answer any questions you may have about costs, payments, NHS benefits, and procedure scheduling. 

For more information about facial palsy and paralysis and the treatment options Mr Townley offers to restore function and aesthetics, we encourage you to contact our office or call 020 3124 1373 to schedule a consultation. During your appointment you will have the opportunity to discuss treatments and corrective surgery for facial palsy in detail.