Selective Neurolysis

Selective Neurolysis

For those who struggle with Bell’s palsy and synkinesis, there are few procedures available that adequately address the side effects. Selective neurolysis, also known as selective neurectomy, is often a beneficial solution to address unwanted facial movements and restore natural-looking expression and function. It works by severing nerves that lead to involuntarily moving muscles while preserving neuropathways that link to the muscles necessary to speak, chew, smile, and otherwise function from day to day. On this page, you can learn more about selective neurolysis. If you’re ready to discuss your options with a trusted professional, we hope you’ll get in touch with the team at Plastic & Reconstructive Surgery – a division of U.S. Dermatology Partners to explore your options.

What Is Selective Neurolysis?

Synkinesis is a common side effect for Bell’s palsy patients who have symptoms that don’t clear up on their own. Synkinesis occurs when multiple nerves are activated simultaneously, causing unwanted and uncontrolled facial movements. This can lead to difficulty smiling and making other facial expressions. Synkinesis also impacts facial symmetry and function. Selective neurolysis is one way to improve the effects of synkinesis. This treatment works by severing nerves that cause unwanted muscle contraction. Facial nerves branch out attaching to muscles. Before performing selective neurolysis, the surgeon carefully maps out the branches to ensure appropriate treatment. By severing certain branches, selective neurolysis prevents unwanted facial movements. For some, this procedure may be combined with selective myectomy, a severing of facial muscles. This is especially true for those who are experiencing extreme muscle tightness or spasms in addition to unwanted facial movements.

Benefits of Selective Neurolysis

Restoring a more natural smile and overall facial function and symmetry are the top benefits of selective neurolysis, but there are many other advantages to pursuing this treatment option, including:

  • Results are noticeable within just a few days of treatments
  • Relatively short recovery time compared to similar treatments
  • Alleviate tightness in the facial muscles
  • Improved muscle control and coordination
  • Improved smile appearance, symmetry, and function
  • Long-lasting results

Recovery After Selective Neurolysis

Compared with similar treatments, the recovery following selective neurolysis is relatively minimal. Depending on the individual’s response to selective neurolysis, the patient may need to stay in the hospital overnight, but most can return home on the same day as their treatment. Your plastic surgeon will provide aftercare instructions to help you heal quickly and minimize any risks associated with the procedure. Within the first few days, patients should begin to see a noticeable improvement in facial expressions. For several months, healing and facial control should continue to improve. Some patients benefit from working with a physical therapist following treatment to further increase facial control.

Risks Associated with Selective Neurolysis

The knowledgeable professionals at Plastic & Reconstructive Surgery have years of experience and advanced training that ensure patients receive the best and safest possible care. They will work with you to minimize risk and ensure you heal quickly and maintain the results of selective neurolysis.

Common risks associated with selective neurolysis include:

  • Damage to surrounding nerves, blood vessels, or muscles
  • Treatment may be ineffective if the surgeon proceeds with too much caution and doesn’t address enough of the overactive nerves
  • Increased loss of facial movement or control
  • Weakened facial muscles
  • Scarring
  • Infection


Sam DeVictor, MD

Sam DeVictor, MD

Board-Certified Plastic Surgeon
Sam DeVictor, MD Request a Consultation “I believe in symmetry, balance, and aging beautifully; helping you achieve the health, wellness, and aesthetics unique to you.” - Dr. Samuel DeVictor PROCEDURESFeatured Procedures Deep Plane Facelift A deep plane facelift delivers more natural-looking and longer-lasting facelift results through the repositioning of deeper face tissues. Rhinoplasty Rhinoplasty is surgery that changes the appearance…