Bell’s Palsy Treatment

Bell’s palsy is a sudden, usually temporary weakness or paralysis of the muscles on one side of the face, caused by a problem with the facial nerve. Common signs are drooping of one side of the face and mouth and difficulty closing or blinking the eye on that side. Most people recover, but some are left with lasting effects.

In chronic Bell’s palsy, targeted botulinum toxin may help restore facial symmetry — often by gently relaxing the stronger, unaffected side so the two halves of the face are better balanced, and by easing over-active or tight muscles and unwanted movements on the affected side. The aim is improved balance and comfort, not a cure.

No. Botulinum toxin does not cure Bell’s palsy or restore facial-nerve function. It is used to manage the lasting effects — particularly asymmetry, tightness and unwanted movements — to improve facial balance and comfort. Dr Nina is honest about what treatment can and cannot achieve at your assessment.

After Bell’s palsy, the unaffected side can appear to overpower the weaker side, making asymmetry more obvious at rest and in expression. Gently relaxing selected muscles on the stronger side can bring the two halves of the face into better balance. The exact approach is individual and decided at your assessment.

Synkinesis is unwanted linked movement that can develop after Bell’s palsy — for example the eye narrowing when you smile — because nerve fibres reconnect imperfectly during recovery. Carefully placed botulinum toxin can help ease the over-active muscles involved, which may reduce these unwanted movements. This is assessed and planned individually.

This treatment is intended for chronic, settled Bell’s palsy rather than the early, recovering phase, which is often best given time first. The right timing is individual and is decided at your assessment, taking into account how your recovery has progressed and any specialist advice you have received.

The effect is not immediate. Reduced muscle action is often noticeable within about five days, with the effect settling by around two weeks, when improved symmetry typically becomes apparent. A review at this point lets Dr Nina assess the balance and refine the plan if needed.

Results usually last a few months before gradually wearing off, after which treatment can be repeated as part of ongoing care. The exact duration varies from person to person, depending on the muscles treated, the doses used and individual factors.

Most people tolerate it well. Very fine needles are used and the injections feel like brief pinpricks. Topical anaesthetic can be applied to sensitive facial areas for added comfort, and the appointment is usually brief.

Downtime is minimal — most people return to normal activities the same day. Mild redness, small bruising or tenderness at the injection sites can occur and settles quickly. We provide tailored aftercare advice.

Botulinum toxin has been used in medicine for many years and is generally well tolerated when planned and placed carefully. As a prescription medicine, it should only be given after a detailed assessment by a qualified practitioner, and facial weakness should be medically diagnosed first. Dr Nina will discuss any less common risks at your consultation.

Side effects are usually minor and temporary: mild redness, small bruising or tenderness at the injection sites. Because the aim is to fine-tune balance between muscles, temporary over- or under-correction or a brief change in expression near a treated muscle is possible, and settles as the effect wears off. A conservative, review-led approach minimises this.

Yes. Treatment is often one part of wider care for chronic Bell’s palsy, which may include facial physiotherapy and the input of other specialists. Where appropriate, Dr Nina will work alongside your existing care and advise on what is suitable, referring on where wider input is needed.

Because every face and every recovery after Bell’s palsy is different, the muscles treated, the doses and the plan are individual to you — so a single list price would not be meaningful. The exact cost is confirmed in writing after your detailed assessment, with no obligation to proceed. A consultation is from £200.

Yes. Because botulinum toxin is a prescription medicine and chronic Bell’s palsy needs individual evaluation, a consultation and detailed assessment are required to examine your facial movement and symmetry, review your history, confirm suitability, set realistic expectations, and agree your bespoke plan and its cost.