Facial Palsy SA

Home
South Africa
Cape Town
Facial Palsy SA

Directions Website

Facial Palsy South Africa is a clinical initiative dedicated to the rehabilitation, education, and advocacy of individuals affected by facial nerve disorders.

28/10/2026

Why does an eye sometimes close when someone smiles after facial palsy?

The answer can lie in how the facial nerve regenerates.

After a significant facial nerve injury, damaged nerve fibres may begin to regrow. Ideally, regenerating axons reconnect with their original muscle targets. However, regeneration is not always perfectly organised. Some fibres may be misdirected and ultimately activate a different group of facial muscles.

The result? When the brain sends a signal for one intended facial movement, additional muscles may activate at the same time.

For example, a person may try to smile and notice the eye narrowing or closing. Others may experience mouth movement during eye closure or unwanted neck/platysma contraction during smiling.

This involuntary linked movement is called synkinesis.

Importantly, synkinesis does not simply mean that the face is still weak. The rehabilitation priorities have changed. Treatment may need to focus less on generating more movement and more on improving movement selectivity, reducing excessive muscle activity and retraining coordination.

Movement has returned, but is your face moving differently?

If smiling causes your eye to close, your neck to tighten, or other parts of your face to move unintentionally, it may be time to reassess how your facial nerve has recovered.

Facial Palsy SA | Understanding movement. Retraining control.

[email protected]
082 511 8212
www.facialpalsysa.com

26/10/2026

Medical gaslighting can happen in facial nerve injury too.

For some people living with facial palsy, one of the most difficult parts of recovery is repeatedly being told that everything is “fine” because their face has started moving again, or because their difficulties are not immediately obvious to someone else.

But movement does not necessarily mean normal movement.

A person may still be experiencing facial weakness, asymmetry, synkinesis, muscle tightness, involuntary eye closure, altered blinking, difficulty eating or drinking, speech changes, discomfort, excessive tearing or significant changes in facial expression.

And these symptoms can have a very real impact on everyday life.

The term medical gaslighting is often used when a person feels their symptoms or concerns are repeatedly dismissed, minimised, or attributed to psychological factors without adequate assessment. Not every disagreement, reassurance or uncertain diagnosis is gaslighting; facial nerve disorders can be complex, and sometimes the clinical picture genuinely evolves over time.

The problem arises when reassurance replaces investigation, or when the patient's lived experience is discounted simply because their symptoms are subtle.

Someone can look “better” and still be struggling.

Someone can regain movement and develop synkinesis.

Someone can have a good recovery medically and still experience meaningful functional or psychosocial consequences.

Good facial palsy care starts with listening, careful assessment and recognising that recovery is about more than whether the face moves.

If something about your recovery doesn’t feel right, it deserves to be explored, not automatically dismissed.

Ask questions. Describe what happens during specific movements. Take photographs or videos over time. And where appropriate, seek assessment from a healthcare professional with experience in facial nerve disorders.

Your symptoms are part of the clinical picture. Your experience matters too.

Contact Facial Palsy SA to enquire about an in-person or online consultation.
[email protected]
082 511 8212
www.facialpalsysa.com

23/10/2026

If you’ve had facial palsy for months or even years, improvement may mean something very different from “getting back to normal.”

In chronic facial palsy, there may be longstanding weakness, asymmetry, synkinesis, muscle tightness or altered movement patterns. Depending on the underlying nerve injury and recovery, complete restoration of previous facial movement may not always be possible.

But that does not mean there is nothing left to work on.

Meaningful improvement may look like:
• Your eye narrowing less when you smile
• A smile that feels easier and more balanced
• Less pulling or tightness in the cheek or neck
• Better control over unwanted movements
• Improved coordination between different parts of the face
• Greater comfort at rest
• Easier eating, drinking or speaking
• Feeling more confident using facial expression again

Sometimes the most important progress is subtle. A movement may become smaller but better controlled. The face may feel softer and less tense. A smile may not become perfectly symmetrical, but it may become more natural, comfortable and spontaneous.

Facial neuromuscular retraining in chronic facial palsy is therefore not simply about making muscles “stronger.” Treatment is individualised according to the person’s presentation and may focus on movement quality, coordination, selectivity, symmetry, relaxation and functional use of the face.

There is an important distinction between cure and improvement. For someone living with chronic facial palsy, progress does not have to mean achieving a “perfect” face. It can mean having a face that moves more comfortably, functions more effectively and feels more like your own again.

Have you been told that because your facial palsy is “old,” nothing more can change?

A chronic presentation does not automatically tell us what can or cannot improve. A detailed facial assessment can help identify what is weak, what is tight, what is moving together and what may still be retrainable.

Don’t measure progress only by symmetry. Measure what your face can do differently.

Contact Facial Palsy SA to enquire about an in-person or online consultation.
[email protected]
082 511 8212

21/10/2026

Not every facial palsy is Bell’s palsy.

Bell’s palsy is a common cause of sudden unilateral facial weakness, but the term should not automatically be applied to every person who develops facial paralysis.

Certain features can suggest that the presentation is atypical and requires further
medical investigation.

These include slowly progressive weakness, recurrent episodes, bilateral facial weakness, additional neurological symptoms, involvement of other cranial nerves (for example, new double vision, difficulty moving the eyes, facial numbness, new
hearing changes, difficulty swallowing, changes in voice, or tongue weakness), as well as a mass or swelling and an unexpected recovery pattern. This does not necessarily mean that something serious is causing the facial palsy. It means that the presentation deserves appropriate investigation rather than assuming that it is Bell’s palsy.

Sudden facial weakness accompanied by arm or leg weakness, speech/language difficulty, severe imbalance, altered consciousness or other acute neurological symptoms should be treated as a medical emergency.

The first step in effective facial rehabilitation is understanding why the facial weakness occurred and how the facial nerve is currently functioning.

Have you been diagnosed with Bell’s palsy but your presentation or recovery seems unusual?

Speak to your treating doctor about whether further investigation is appropriate.

For assessment and rehabilitation of facial movement, contact Facial Palsy SA to enquire about in-person or online facial neuromuscular retraining.

[email protected]
082 511 8212
www.facialpalsysa.com
In-person consultations in Cape Town
Online consultations available

19/10/2026

Did you know that approximately 1 in 60–70 people may experience facial palsy during their lifetime?

Facial palsy can affect anyone, at any age, and may develop suddenly or as a result of a range of different medical conditions.

The effects can extend far beyond how the face looks. Depending on the cause and severity, facial palsy may affect:
• Facial movement and expression
• Eye closure and eye comfort
• Eating and drinking
• Speech
• Facial sensation or discomfort
• Confidence and social interaction

Every person’s facial palsy journey is different. Understanding the condition, identifying the underlying cause and accessing appropriate care can help people make informed decisions about their recovery and rehabilitation.

Awareness builds understanding and reminds those living with facial palsy that they are not alone.

Don’t just wait and wonder about your recovery. Learn what’s happening, what to look for, and what support may be appropriate.

Contact Facial Palsy SA to enquire about an in-person or online consultation.
[email protected]
082 511 8212
www.facialpalsysa.com

14/10/2026

So, what actually happens during a facial palsy consultation?

Many people arrive expecting to be given a list of facial exercises. But effective facial rehabilitation starts with assessment and understanding.

We look carefully at how your face moves at rest and during different expressions, document movement using photographs and video, and discuss the findings with you. Depending on your presentation, we may assess areas such as facial weakness, symmetry, muscle tightness,
movement control and synkinesis.

From there, we develop an individual treatment plan and home programme based on your facial movement pattern, stage of recovery and goals.

Follow-up is equally important. As facial function changes, your programme needs to change too.

Facial rehabilitation is not about exercising harder. It is about learning to move better.

Living with facial palsy, persistent facial weakness or synkinesis?

Contact Facial Palsy SA to enquire about a comprehensive facial assessment and individualised facial neuromuscular retraining.

[email protected]
082 511 8212
www.facialpalsysa.com

In-person consultations in Cape Town
Online consultations available

13/10/2026

Living with bilateral facial palsy can affect so much more than facial movement. Recovery and rehabilitation can require patience, persistence and a carefully individualised approach.

These photos reflect the progress achieved through consistent facial rehabilitation and dedicated home practice. Changes may happen gradually, but over time, improved facial control, symmetry and movement can make a meaningful difference.

Facial rehabilitation is not about forcing movement or doing endless facial exercises. It is about understanding the individual pattern of facial function, retraining movement carefully, and practising the right strategies consistently.

A wonderful reminder that dedication and consistency pay off.

Photos shared with patient consent.

Are you living with facial palsy or struggling with ongoing facial weakness, asymmetry or unwanted facial movements? Contact Facial Palsy SA to find out more about a comprehensive facial assessment and individualised facial neuromuscular retraining. Online and in-person consultations are available.

[email protected]
082 511 8212
www.facialpalsysa.com

09/10/2026

Did you know that facial palsy can affect both sides of the face?

Bilateral facial palsy means that there is weakness or paralysis affecting the facial nerve on both sides of the face. It is much less common than unilateral facial palsy and can sometimes be more difficult to recognise because there may not be an obviously “unaffected” side for comparison.

Someone with bilateral facial palsy may experience difficulty with:
• raising the eyebrows or creating facial expressions
• closing the eyes completely
• smiling or showing the teeth
• keeping food or liquid contained in the mouth
• controlling the lips during eating, drinking or speech
• communicating emotion through facial expression

Importantly, bilateral facial palsy is a description of the facial weakness and is not a diagnosis in itself. There are several possible underlying causes, which is why appropriate medical investigation is important, particularly when facial weakness is new or unexplained.

Once medically appropriate, facial rehabilitation can focus on supporting the individual’s facial rehabilitation journey. Depending on the stage and presentation, this may include education, movement retraining, improving movement control and symmetry, managing tightness or unwanted movements, and developing an individualised home programme.

Two sides affected does not mean that both sides will behave in exactly the same way.

Careful assessment helps us understand what each side of the face is doing and what rehabilitation approach may be appropriate.

Living with bilateral facial palsy?

A comprehensive facial assessment can help identify your current movement patterns and determine appropriate rehabilitation goals.

Contact Facial Palsy SA to enquire about an individualised facial assessment and facial neuromuscular retraining.

[email protected]
082 511 8212
www.facialpalsysa.com
In-person consultations in Cape Town
Online consultations available

07/10/2026

When we assess facial palsy, we don't only look at what happens when you smile, close your eyes or raise your eyebrows.

Your face at rest can provide valuable information too.

Before asking you to move, we observe:

Resting symmetry: How do the two sides of the face compare when completely relaxed?
Muscle tone: Are there areas that appear tight, shortened or unusually relaxed?
Eye position: Is there a difference in eye opening or resting eyelid position?
Mouth position: Is there asymmetry around the lips or corner of the mouth?
Unwanted muscle activity: Is there evidence of increased activity or synkinesis, even when you are not deliberately moving?

These observations help us build a more complete picture of your facial presentation and guide an individualised rehabilitation plan.

Facial rehabilitation isn't only about creating a bigger smile. It is about understanding how your face rests, moves and coordinates as a whole.

A relaxed face still tells us a story.

Have you noticed that your facial asymmetry or tightness is present even when you're not moving?

A comprehensive facial assessment can help identify what is happening and guide the next steps in your rehabilitation.

Contact Facial Palsy SA to enquire about an in-person or online consultation.

[email protected]
082 511 8212
www.facialpalsysa.com

05/10/2026

How can Facial Palsy SA support your recovery?
Facial palsy rehabilitation is not a one-size-fits-all programme, and it is not simply about doing facial exercises.
Your treatment should reflect your facial movement, your stage of recovery, your symptoms and your individual goals.

At Facial Palsy SA, we provide comprehensive facial assessment, individualised treatment planning, facial neuromuscular retraining, synkinesis management, education and support, and collaborative care where appropriate.

Whether your facial palsy is recent or you have been living with residual weakness, tightness, asymmetry or synkinesis for years, understanding what your face is doing now can help guide the next steps in your rehabilitation.

Not sure what the next step in your facial recovery should be?
Contact Facial Palsy SA to enquire about a comprehensive facial assessment.

Online consultations available
In-person consultations in Cape Town
[email protected]
082 511 8212
www.facialpalsysa.com

Address

Head Quarters
Cape Town
7400

Website

http://www.facialpalsysa.com/

Alerts

Be the first to know and let us send you an email when Facial Palsy SA posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.