Facing the future with confidence.
Life-changing treatment for facial paralysis helps patients smile again
Jacob K. Dey, M.D.
Facial Plastic and Reconstructive Surgeon
Rochester, Minnesota
“Some surgeons perform life-saving surgery. I like to say I perform life-changing surgery.”
“Some surgeons perform life-saving surgery.” A big smile fills Dr. Jacob Dey’s face. “I like to say I perform life-changing surgery.” For patients with facial paralysis, restoring their ability to smile can be the life-changing result they need.
As a Facial Plastic and Reconstructive Surgeon within the Department of Otolaryngology (ENT)/Head and Neck Surgery in Rochester, Minnesota, Dr. Dey brings faces back to life with facial reanimation surgery. For example, suppose someone has lost facial function due to nerve damage from Bell's palsy, Ramsay Hunt syndrome, a parotid tumor, a skull base tumor, or a stroke. Dr. Dey and his team can work with that patient to develop an individualized treatment plan for facial reanimation. This can include innovative treatments such as nerve rewiring, nerve transfer surgery, muscle transplant surgery, or other procedures that can restore facial symmetry and function.
“We’re social creatures. Communication is an essential part of life,” says Dr. Dey. “And our face is how we communicate. It’s our sense of identity. When a patient has a facial deformity, a facial difference, or a paralysis where they cannot move a portion of their face, that dramatically impacts their day-to-day life.”
As a medical student, Dr. Dey found a passion for surgery: “It’s a very privileged and intimate interaction where someone is saying ‘I am going to entrust my life and my quality of life to you,’” he says. “I was fortunate to have phenomenal mentors that sparked my interest in facial plastic and reconstructive surgery.”
Early on, one particular experience helped shape his focus. “We had a patient who was unable to smile. And I could see how profoundly it affected her,” he says. “I was lucky to be part of the team that helped reanimate her face. To this day, I can remember seeing her after surgery and watching her smile for the first time in years. That moment solidified my interest in facial plastic and reconstructive surgery.”
Dr. Dey describes facial reanimation as a catchall term. He equates it to a toolbox. And in that toolbox, many procedures and surgeries help recreate facial symmetry and function. “Not every facial plastic surgeon has every tool available,” he says. “With my training and our team, we offer all the tools, from nonsurgical treatments like Botox and fillers, to surgical treatments like nerve and muscle transfers, to treating patients with aberrant reinnervation through select muscle and select nerve cuts.”
One of Dr. Dey’s primary focus areas is facial paralysis. “The effects of facial paralysis can be devastating,” he says. “I had a patient with a tumor of her skull base that weakened her facial nerve. The surgical team removed the tumor, and in doing that, a portion of her facial nerve had to be removed, resulting in complete facial paralysis on one side of her face. In our first meeting, she told me of an encounter with a young boy at a grocery store. The little boy had walked up, and she smiled to say hello. Because of the severe asymmetry of her smile, the boy ran off crying. It made her heart sink.”
“As patients sit with me in clinic, they are often crying. And I have great empathy for them. But I also get to do something extraordinary. I get to provide them with a solution—with hope.”
“I was fortunate to discuss options for facial reanimation with her,” he says. “We ended up doing muscle transplant surgery where we took muscle from her inner thigh to reconstruct or replace the muscles of her face, carefully connecting its blood supply to the neck and connecting it to a new nerve. Now she can smile with her whole face, and that is life changing.”
“It’s emotional when you can’t connect with other people; when you can’t reciprocate a smile,” he says. “As patients sit with me in clinic, they are often crying. And I have great empathy for them. But I also get to do something extraordinary. I get to provide them with a solution—with hope. Almost always, there is something we can do to help someone with facial paralysis. Once the procedure is complete, there are often more tears. But at this point, they are tears of joy. That’s what drives me to keep doing what I’m doing, to innovate and work to push the needle forward. And each day say, what can we do today to make things a little bit better as we continue to help patients?”
What does Dr. Dey see for the future of facial reanimation? “It’s a hotbed for innovation, which is professionally exciting but also incredibly moving to offer these new treatments to patients,” he says. “Each year, we better understand the microanatomy of the facial nerve and the pathophysiology of facial nerve injury and recovery. This informs us to design more effective treatments for facial paralysis. Personally, I want to increase awareness about treatments. It amazes me that there are still so many facial paralysis patients in the world who believe they have no other options.”
“I’m also fortunate for my advanced aesthetic training, which allows me to approach facial reanimation patients with an artistic eye,” says Dr. Dey. This combination of expertise in facial reanimation and aesthetic facial surgery helps Dr. Dey get the best possible outcomes for his patients. “Unfortunately, some people still think of aesthetic procedures as solely cosmetic. But I argue that if a patient is experiencing distress because what they see in the mirror doesn’t match how they feel on the inside, that patient is worthy of treatment. They are worthy of a change to improve their quality of life.” Dr. Dey sees a cultural shift happening around the stigma of plastic surgery. “More and more people are open about having had aesthetic facial plastic surgery. And so I think some of that stigma is going away.”
"It is so gratifying to play a role in restoring someone’s quality of life. It truly is a life-changing procedure. Each day is a gift for me to work with my team and make a positive impact.”
For every smile Dr. Dey repairs through facial reanimation, his own smile keeps growing. “It is so gratifying to play a role in restoring someone’s quality of life. It truly is a life-changing procedure. Each day is a gift for me to work with my team and make a positive impact.” Because at the end of the day, Dr. Dey realizes he’s not just reanimating a face. He’s reanimating a life.
Jacob K. Dey, M.D.
Dr. Jacob Dey is a Facial Plastic and Reconstructive Surgeon and a leading expert in the rare subspecialty of facial reanimation. His team helps people who need repair or reconstruction of the facial nerve, and he has developed breakthrough techniques that help patients with facial paralysis. In addition to reconstructive surgery, Dr. Dey also specializes in aesthetic facial plastic surgery. His unique combination of expertise in facial aesthetic surgery and facial reconstructive surgery helps him provide the best possible results for his patients.
Center for Aesthetic Medicine & Surgery
The Center for Aesthetic Medicine & Surgery in Rochester, Minnesota, is a comprehensive multispecialty center offering the cumulative knowledge of an integrated medical team to meet your unique needs in an appropriate environment.
Bell’s palsy
A condition that causes sudden weakness in the muscles on one side of the face. Rarely, plastic surgery may be needed to correct lasting facial nerve problems. Facial reanimation surgery helps make the face look more even and may restore facial movement.
Ramsay Hunt syndrome
Ramsay Hunt syndrome is caused by the same virus that causes chickenpox and shingles. After symptoms clear, the virus still lives in your nerves. Years later, it may reactivate. When it does, it can affect your facial nerves.
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