Management of Paresis

Paresis means the stage when the face is still weak after paralysis but not completely floppy. This stage would normally occur at least three month after diagnosis of facial palsy. Some basic exercises are included in the videos below but these should never be done when the face is still floppy as you could make things worse rather than better.  For a bespoke exercise plan including more detailed exercises you will need guidance from a specialist therapist. The videos in this set demonstrate basic smile, lip rounding and eye exercises which may be helpful. They should not be done by anyone who has had their facial palsy less than 3 months. Please listen carefully to the instructions.

Frequently asked questions:

Can you still do these exercises if you receive Botulinum toxin injections for synkinesis?

You should not do any massage on the same day as the injections but you should start massage again the next day. It takes two weeks for Botulinum toxin injections to reach full effect. While it’s settling down during those first two weeks and the face is changing it might be harder to do the exercises but it is okay to still do them if you feel you are able to. People who receive botulinum toxin injections should definitely still be doing brain/movement retraining exercises, the injections calm down synkinesis giving a window of opportunity where exercise and soft tissue work can be more easily carried out. The movement relearning process should eventually lessen and remove the need for injections long term.

Are these exercises beneficial to someone who has had a facial nerve graft?

In terms of facial nerve grafting then yes if the facial nerve itself has been reconstructed, patients would also need to do appropriate massage and soft tissue release to reduce facial muscle stiffness facilitating movement. For people who have had surgery to replace the facial nerve with another nerve or have had muscle transfers these exercises would NOT be appropriate and they need a specific exercise programme from a specialist therapist.

If you are newly diagnosed and watch this video, please don’t be alarmed by the statement that says ‘After a facial palsy it is not possible for the face to simply start working again as it did before. Movements have to be learned from scratch.’ This video is aimed at people who have not made a complete recovery after three months.


Smile exercises

Lip rounding exercises

Eye exercises

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Last reviewed: 05-01-2019    ||    Next review due: 05-01-2022