Facial palsy surgery- stage two

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.at home.

Your physiotherapist: Edel

Edel will teach you some exercises to help your new muscle learn how to work.

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 physio 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. Mr Woollard will talk to you about the operation and make sure you know what is going to happen.

In this operation, the muscle is taken from under your arm (or sometimes your leg) and transplanted to your cheek. The surgeon will remove the muscle by making a cut under your armpit. This will all happen when you are asleep, so you won’t feel this.

After the operation, you will wake up in recovery with a nurse who will look after you. 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 medicines through the tube and have fluids to keep you hydrated. You will also have a small drain under your arm to help with any swelling. A drain is a small bottle connected to a tube to let any swelling under your arm come out. You will also have a tube that helps you wee (a catheter). The catheter will be taken out after 1 or 2 days when you feel more awake.

You will then go to Panther ward for seven nights. You will be encouraged to eat, drink and walk around.

You will have a cut on one side of your face and under your arm. You will have a bandage wrapped around your head and a bandage under your arm to keep these cuts protected. There will be some stitches too to help the cuts close. Sometimes these stitches fall out by themselves or sometimes the nurses need to take them out a week later. The doctor will tell you which stitches you have after your operation. The day after your surgery Mr. Woollard and his team will come to remove your bandages on your face and your arm and check that everything is ok.

You will have six weeks off school and off PE or any other sports that you normally do.

You can walk around when you feel ready, but you will need to keep your face and your arm safe while everything heals to stop any accidents happening which might make you feel sore or delay the healing.

It is best to only eat soft things for two weeks- avoid hard foods like apples.

It is recommended to bring pyjamas that button up the front so that it is easier to put on and take off after your operation. You will have a bandage on your head so clothes that pull on over your head will be difficult to put on.

Your face will be bruised and swollen after the operation, but this will improve over time.

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 unique to you!

On day seven, if you have stitches that need to be taken out, you will go to Magpie to see Gaynor and Brigette. Gaynor and Brigitte will take these out; Jade can come too if you are nervous.

After one week at home, you will have a video call 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.

After six weeks you will have a video call with Edel. You will practice touching your face and doing gentle massage.

You will practice touching and massaging your face.

You will have a check-up appointment after three 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.

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

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