The ultimate face-saving feat

If half your face were paralyzed, it would be hard to eat or drink, smile, talk normally, or even blink on that side. And because facial appearances and expressions play such key roles in social interactions, the paralysis would bring with it some difficult personal consequences.

“It was scary. Very scary,” says Brianna Eli, a nurse from North Dakota  in her mid-20s who knows firsthand the debilitation—and the stigma—that go with the condition.

A benign tumor growing on the nerves in Eli’s left ear took her hearing in that ear and also damaged the nerves on that side of her face, leaving it paralyzed. On referrals from doctors, Eli sought out Dr. Sofia Lyford-Pike, chief of the University of Minnesota Medical School’s Division of Facial Plastic Surgery.   

The worst damage lay with a nerve that controlled some of the muscles on the left side of Eli’s face. It could neither be repaired nor recover on its own. There was only one thing Lyford-Pike could do.

‘The way I describe it to patients is we have to rewire their faces,” she explains.

Tapping into a new life

The troublesome nerve was one of 12 nerves, called cranial nerves, that run straight from the brain to their target organs, rather than first going through the spinal column. Most of them serve tissues in the head. Number seven, called the facial nerve, serves facial muscles and was the one knocked out of commission on her left side. It controls actions like elevating a brow, closing an eye, scrunching a nose and flashing a smile.

In a five-hour microsurgery, Lyford-Pike used a tiny needle and thread to tap into electrical signals from other nerves. For instance, to give Eli her smile back, she hooked into a branch of the nerve feeding the chewing muscle.

Through physical therapy, Eli has learned how to operate her newly rewired face. One lesson: To smile, bite down. Now, she can smile just by thinking about it. “That’s exciting,” she says.

“It’s really a testament to how adaptable, or ‘plastic,’ the human body is,” notes Lyford-Pike.

Two years into her recovery, Eli still sees Lyford-Pike for Botox injections on the right side of her face “to kind of even it out a little more.” Eli also looks forward to a career as a nurse practitioner, seeing patients who will learn from her “there’s hope.”

And Lyford-Pike has one reason to envy her.

“She’s going to be able to empathize with patients in a way that I simply can’t,” she says.