https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/facial-palsy-surgery-stage-2-a-picture-guide/

Facial palsy surgery- stage 2- a picture guide

You have already had the first part of your operation. Well done!

This webpage tells you about the second part of your operation and is a reminder of all the people you will meet when you are in hospital!

Entrance of Great Ormond Street Hospital for Children, featuring vibrant and whimsical decorations such as suns, rainbows, butterflies, flowers, leaves, and fruits. The hospital name is prominently displayed above glass doors beneath a glass canopy supported by blue pillars, with hanging flower baskets flanking the entrance.

Meet your team

Mr. Woollard is your Consultant Surgeon

He will be the person doing your surgery.

Talk to Mr. Woollard about any aspects of your surgery, recovery, and outcomes.

Mr Woollard

Gaynor and Brigitte are your Specialist Nurses.

They will see you before and after your operations. They will check your stitches and make sure that everything is ok.

Talk to Gaynor and Brigitte about how to care for your cuts and scars at home.

Gaynor and Brigitte

Edel is your Physiotherapist.

Edel mainly helps you after the second part of your operation. After your first operation, Edel will come to say hello and check you feel happy to walk around.

Talk to Edel about your recovery, movements in your face and how you can help exercise your muscles.

Edel

Jade is your Play Specialist.

Jade will help you to:

Understand each step in your journey.
Help you to make decisions about what or how you would like things to happen.
Help you with anything that is worrying you.

Talk to Jade about your anaesthetic and any questions or worries that you have.

Jade

What happens during the second stage?

A small muscle from under your arm (or sometimes from your leg) is taken out and moved to help the muscles in your face! Don’t worry, this is a spare muscle so you can still move your arms and legs and play exactly as before.

The day before the surgery

On Wednesday afternoon, you will come to the hospital and meet Edel and Jade to say hello.

You will then meet the specialist nurses (Gaynor or Brigitte) and the nurse associate. They will talk to you about the operation. They will also do swabs, check your weight and height and take your temperature.

Three medical devices are displayed: a black and white swab with a cap, a white wheeled chair with armrests and footrests in the centre, and a digital scale with an attached height measuring rod on the right.

Swabs, weight, height

Then you will meet one of the junior doctors. They will listen to your chest with a stethoscope and ask some questions.

A stethoscope with red tubing and grey earpieces. The circular grey chest piece is connected to the red tubing, which loops around and splits into grey tubing leading to the earpieces

The senior doctor might also come to tell you more about the operation. The adult who looks after you might have to sign an important piece of paper.

After seeing all these people, you can go to the patient hotel. You will stay there for one night with the person who looks after you.

The next morning, you will have to get up very early and come to the hospital (don’t worry, it’s only across the road!)

On the day of the surgery

You will come to Woodpecker ward.

You will be given a room.

A hospital room with a single bed covered in a blue and white patterned blanket, positioned near a window. To the right of the bed is medical equipment including a monitor and tubes. On the left side, there is a sink with wall-mounted soap dispensers and an office chair. The walls are painted green and white.

You will meet one of the nurses or a healthcare assistant.

The person on the left wears a blue uniform with pens in the chest pocket, and the person on the right wears a green uniform with pens in the chest pocket. Medical equipment and supplies are visible in the background

They might weigh you and measure your height again!

Two medical devices: a white chair with black armrests and footrests mounted on four wheels, and a digital scale with an attached height measuring rod and a small display screen for readings.

They will take your observations:

Medical devices in use on a person's arm and hand: a thermometer strip on the forehead, a blood pressure cuff wrapped around the upper arm, and a pulse oximeter clipped onto a finger

Temperature, blood pressure, O2 stats

You might need to do some swabs again too.

Don’t worry! These are not the same as the Covid swabs and do not hurt.

A swab featuring a long, thin cotton-tipped swab and a cylindrical plastic tube with a black cap

You will be given a gown to wear.

A young child lying in a hospital bed, wearing a hospital gown and covered with a blanket.

And a wristband that will be scanned with a red light.

This is so we can check your name, special hospital number and birthday!

A person in a white coat scans a patient's wristband using a barcode scanner. The patient is lying in bed with their arm extended, and the wristband is white with red markings.

The different doctors will come to talk to you.

Mr. Woollard or one of his team will come to talk to you about the operation.

They might want to listen to your chest and back.

In a medical setting, a patient in a hospital gown sits on a bed while a healthcare professional in a white coat uses a stethoscope to listen to the patient's chest

The anaesthetist (sleepy doctor) will come to talk to you about your sleep and the different ways to do this.

Going to sleep

There are 2 ways you can go to sleep for your operation.

Using a mask:

The mask goes on your face, over your nose and mouth.
You breathe in the sleepy medicine.
The mask is soft and does not hurt.
The medicine can smell quite strong and might make you feel a bit dizzy.
You can use lip balms to help with the smell.
You can play a game and blow bubbles through the balloon.
It can take a couple of minutes until you are asleep.

A clear plastic oxygen mask with a blue connector is shown on the left. On the right, a stuffed bear lies on a bed, covered with a purple blanket, while someone holds an oxygen mask over its face.

Using a cannula:

A cannula is a small bendy tube that goes into your hand or arm.
The cannula goes in with a needle, but this comes straight out and only the small bendy tube stays in.
You can have numbing cream or cold spray to help take away some of the feeling.
The cannula is secured using a plaster.
The sleepy medicine can then be put through the cannula. This can sometimes feel a bit cold, tingly, or stingy. Think of all your favourite things!
You will fall to sleep very quickly.

On the left, a medical device—an intravenous (IV) catheter—is shown. It features a small, flexible tube that is inserted into a vein using a needle. The catheter includes stabilising wings on either side. On the right, a teddy bear lies on a bed with a purple blanket while two hands hold its arm, simulating the administration of an IV using a similar device.

Going to the operation

You will then come to theatres.

Collage of three hospital photos: the first shows a reception area with two medical staff in blue scrubs and red shoes, one seated and one standing; the second shows a hallway with another staff member in blue scrubs and red shoes, with signage for 'Theatres'; the third shows an empty corridor decorated with colourful letters and symbols on the walls.

And find the anaesthetic room where you will have your sleep.

A hospital operating room with a bed holding a teddy bear covered by a blanket. The room includes medical equipment such as monitors, an anaesthesia machine, and storage cabinets with supplies. A clock is mounted above double doors in the background.

You will then use either the mask or cannula to go to sleep.

What happens when I am asleep?

A muscle will be taken from under your arm (or sometimes from your leg) and placed in your cheek. This will all happen when you are asleep, so you won’t feel this.

A diagram of a person's face, sowing a nerve under the nose, being connected with a nerve in the cheek

Where will I wake up?

You will wake up in recovery with a nurse who will look after you.

A person in medical scrubs and a hairnet stands beside a hospital bed with colourful padded side rails featuring geometric patterns. A stuffed animal wrapped in a purple blanket lies on the bed.

You will have a cannula in your hand or arm, even if you went to sleep with the mask. This is so you can have your medicines through the tube and we can give you fluids.

Close-up of a small child's hand wrapped in white bandages, resting on light blue and white bedding.

You will also have a big bandage wrapped around your head. To help with the swelling you will have two small tubes – one in your cheek and one under your arm.

A brown teddy bear sitting on a light blue surface with bandages wrapped around its head and left arm, suggesting it is injured or recovering.

You will be taken to Panther ward when you are feeling more awake.

Split image: on the left, double doors with a green sign above reading 'Premier Inn Clinical Building', surrounded by various signs and notices; on the right, an illustration of a black panther sitting upright with its tail curved upwards.

The adult who came to hospital with you will be waiting in your room.

Hospital room with a bed featuring green and blue railings and a pillow. In the background, a purple chair sits beside a window. Medical equipment, including monitors and cables, is mounted on the wall.

The nurse will do more observations and will encourage you to eat, drink and play. This is important to do so that you can go home when the nurse and doctors are happy!

You will stay overnight for 1 sleep.

What happens after my operation?

The next day Mr. Woollard and his team will come to remove your big bandage on your head and will look at your face and under your arm to check that everything is ok.

You will have a small cut on the side of your face and stitches. Sometimes these fall out by themselves or sometimes the nurses need to help. The doctor will tell you which stitches you have.

Your face will look and feel different. It will be bigger because the new muscle is in there.

You will stay overnight for 6 sleeps with the adult who looks after you.

When this is all finished you will be able to go home.

Two emojis side by side: a house with a yellow door and blue-paned window on the left, and a hand waving with motion lines on the right.

Things to remember:

You will have 6 weeks off school.

You will have 6 weeks off PE or any other sports that you normally do.

You can walk around straight away but you will need to keep your face and your leg safe while everything gets better, so no super-fast running around!

It is best to only eat soft things for 2 weeks- no hard crunchy apples!

It is a good idea to bring pyjamas that button up the front so that it is easier to put on and take off after your operation.

An image of blue and white stripy pajamas

One week later

You will have a video appointment with Gaynor or Brigitte and Edel to check you are feeling well. It will be time to take any remaining bandages off and to start rubbing cream into your face and under your arm.

Check up after 6 weeks

Edel will do a 6-week check-up.

Usually this will be on video.

You will practice touching your face and doing gentle massage.

Check up after 3 months

You will go to the clinic on Magpie ward to see Mr. Woollard and the team to look at how your face and scars are healing.

If Mr. Woollard is happy, you can start your new exercises with Edel.

You will see Edel lots after this, to train and teach the new muscle how to work.

It is important to remember that everybody’s smile is different. So, after the operation your smile will not be the same as anyone else’s smile. This is ok because your smile is special to you!

You may see Mr. Woollard for more check-ups after your operation.

Compiled by:

Plastic surgery

Last review date:

September 2025

Ref:

0925PAT0026