Facial palsy surgery- stage one

Your surgeon: Mr Woollard

Mr Alex Woollard is the consultant surgeon who will do your surgery.

You can talk to Mr Woollard about any aspects of the surgery, recovery, and outcomes.

Your clinical specialist nurses: Gaynor and Brigitte

Your clinical specialist nurses Gaynor and Brigitte will see you before and after your operations. They will check your stitches and check that your face is healing well.

You can talk to Gaynor and Brigitte about how to care for your cuts and scars and about any worries you may have.

Your physiotherapist: Edel

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

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

Your play specialist: Jade

Jade’s job is to help you understand each step in your journey, to help you make decisions about what or how you would like things to happen and help you with anything that you might be worried about.

You can talk to Jade about your anaesthetic and any questions or worries that you might have about being in hospital.

• Attend a play and physiotherapy assessment with Edel and Jade.
• Attend a pre-operation appointment with Gaynor, Brigitte and a junior doctor. They will:
  • Check your height and weight.
  • Do swabs to check that you are healthy for your operation.
  • Check that they are happy for the surgery to go ahead.
  • They will also explain about fasting before the operation- you should not eat and drink anything on the day that you have your operation. This is because your stomach needs to be empty when you have your anaesthetic.
• You will also meet one of the junior doctors who will listen to your chest with a stethoscope and ask you some questions. A senior doctor might also come to tell you more about the operation. You and your parent/ carer will sign the consent form if you agree to have the surgery. Some patients need to stay in the patient hotel the night before their surgery.

On the day of the surgery, you will go to Woodpecker ward. The anaesthetist and Mr Woollard (the surgeon) will come and talk to you. The anaesthetist will offer you options of how you would like to go to sleep- usually either a mask or cannula (a thin tube that goes into your vein)- and will explain how these work. Mr Woollard will talk to you about the operation and make sure you know what is going to happen.

In the operation your sural nerve (in your lower leg) is taken and attached to the nerves in your face. Your surgeon will remove the nerve by making a small cut in the back of your leg, this will all happen when you are asleep, so you won’t feel this.

When the operation is finished you will wake up in recovery with a nurse who will look after you. You will have a cannula (a thin tube) in your hand or arm, even if you went to sleep with the mask. This is so you can have medicines through the tube and have fluids to keep you hydrated. You will then go to Panther ward for one night.

You will have a small cut on one side of your face and on your leg, there will be some stitches too to help the cuts close. You will have a bandage wrapped around your head and a bandage on your leg to keep these wounds protected.

You will be encouraged to eat, drink and walk around. The next day Mr. Woollard or his team will come to remove your bandages on your face and on your leg and check that everything is ok. When everyone is happy that you’re ready, you can go home.

• You will have to take two weeks off school and PE or any other sports that you normally do.
• You can walk around straight away but you will need to look after your face and leg while everything heals.
• It is best to only eat soft foods for two weeks- avoid hard foods like apples.
• We recommend bringing pyjamas that button up at the front so that it is easier to put on and take off after your operation.
• Your face will be a little bit bruised and swollen after the operation, but this will go away. There is no new muscle yet so your face will look and move in the same way as it did before the operation.

• You will have either a video or face to face visit with Gaynor or Brigitte, and Edel after one week. This is to check how you are doing. At this stage you can remove any remaining bandages and start rubbing cream into your face and leg. You may also need to have your stitches removed after 7-10 days.
• You will have an appointment after three months on Magpie ward. This will be with Mr. Woollard and the team to look at how your face and scars are healing. You will talk about the next stage of your surgery and ask any questions that you may have. Sometimes Mr. Woollard will do a gentle tapping on your face to check everything is healing well after surgery.

Changing Faces are a charity who provide support and promote respect for people growing up with a visible difference.

You can visit their website here: Changing Faces website

Or call them: 0300 012 0275

If you have any concerns about your upcoming surgery or would like more information about anything in this leaflet, please email:

• Edel: edel.debuitleir@gosh.nhs.uk

• Jade: jade.sanders@gosh.nhs.uk