When Nick woke up from an operation to remove an acoustic neuroma, he found out that he had facial palsy. But a sophisticated surgery procedure, the Labbé technique, has given him his smile back.
Nick at the coast
I’d been diagnosed with an acoustic neuroma – in plain English, that’s a non-cancerous tumour of the nerve that connects the ear to the brain. Surgery would get rid of it, but the doctors warned me of possible complications. My worst fear was to be left with facial paralysis.
My worst fear was realised on 12th May 2008. I woke up with a droopy face, and started struggling with day-to-day life.
I have a very social job in catering. It took time for me to feel comfortable at work, but luckily I see mostly the same people every day. I still found making eye contact, or confronting someone, quite difficult.
Outside work, I just tried to avoid situations that would make me ill at ease. I wouldn’t go to functions or gatherings. I’d ask my partner to do the talking in shops. I didn’t want my photo taken because whenever I saw a picture of me, I was upset to find out that I looked worse than I thought, and I would feel gutted.
Nick after tumour removal
I was told about the relatively new Labbé technique developed by a French surgeon, and that gave me some hope. It involves lengthening the temporalis muscle (a fan-shaped muscle on the temple that moves the jawbone when you chew) and branching some off, breaking the cheekbone to feed some muscle through and connect it to the corner of the mouth. It can significantly improve facial symmetry.
Before the operation, I tried not to believe too much that it would work – but I couldn’t help being very excited at the prospect of looking normal again. I knew I would never look like I used to, but any improvement would be a bonus. I also tried to block out the scary thought that the surgeons were going to peel my face off like a mask during the procedure!
I went into hospital the night before the op. The following morning, the registrar explained in great detail what was going to happen. I thought I was just in for the Labbé technique, but I discovered that I would also be having a cross facial nerve graft: this involves removing one of the nerves from the calf, then attaching one side to the working facial muscle, and the other to the temporalis muscle on the palsy side. In time the nerve would grow and prompt the muscles to move at the same time as the other side, giving a more spontaneous smile. I didn’t argue: ‘I’ll have anything that will help,’ I thought.
The operation took nine hours. I woke up around 7:30 p.m. I was feeling very drowsy, and I kept drifting in and out of sleep. At about 1 a.m., I asked for someone to hand me my phone and I took a picture of myself. I was all wrapped up in bandages with one eye and one ear showing, and a straight mouth! I almost screamed out loud with excitement. I even managed to text my photo to almost everyone I knew, and I posted it on Facebook… The drugs must have really knocked me out: I only realised all this a few days later, when several people got in touch with me.
The following day, the nurses removed the bandages and one of the head drains. I had 49 staples from one ear to the other and a big dressing on my left leg where they had taken the nerve from. My leg felt quite painful, and numb with pins and needles.
A day later I had the rest of the drains removed, and I was ready to go home before lunch.
After 10 days the staples were removed, as well as the bandages from my leg. I had my first physiotherapy session. The physio talked me through the exercises that I would have to do regularly: massage, stretches, and smiling. My mouth needed stretching seven times a day as it was very tight. I found eating difficult to start with; I could only manage soup and soft bread. It got really boring so I’ve found ways to be a little bit more adventurous with my food. I can still only swallow small forkfuls, but every day I notice some improvement.
6-8 weeks after Labbé surgery
Four weeks after surgery, I felt ‘normal’ again and so much more confident. I was happy to go out and meet people. I knew that the visible scar from my nose to the corner of my mouth would eventually fade and look like a smile crease.
Paradoxically, the scar didn’t bother me, because people looking at me could see that something has ‘happened’ to me – whereas before, with no obvious evidence of damage, I looked like there was something ‘wrong’ with me. I guess it is part of the psychological problem for someone trying to deal with facial paralysis – it is for me, anyway.
It’s been six weeks now since the op, and I feel happier than ever, full of energy and looking forward to eating out, going on holidays… all the things I used to dread. I will need a few minor adjustments to my mouth to bring up my lip, but that’s nothing compared to what has already been achieved.
It looks like my life has started again after being on hold for 18 months.
Surgery video
Below is a video Nick made of before and after his Labbé surgery.
Disclaimer: Please note that views expressed are person’s own and should not be considered a recommendation of particular medical treatments, therapies or surgeries. We would always advise you seek advice from a health professional with experience in facial palsy who can assess your individual needs.