Moebius Syndrome(Congenital Bilateral Facial Paralysis)
Specialized pediatric and adult facial reanimation to restore expression and the ability to smile.
What is Moebius Syndrome?
Moebius syndrome is a rare, congenital (present from birth) neurological condition. It is primarily characterized by weakness or complete paralysis of multiple cranial nerves, most commonly the 6th cranial nerve (which controls lateral eye movement) and the 7th cranial nerve (the facial nerve, which controls facial expression).
Unlike unilateral congenital palsies that affect only one side, Moebius syndrome frequently affects both sides of the face (bilateral paralysis). This means infants born with Moebius syndrome are often entirely unable to smile, frown, suck, grimace, or blink their eyes.
Because facial expressions are a fundamental part of human communication, growing up without the ability to smile can be socially and emotionally isolating for children. However, life-changing surgical techniques are available to give these patients the gift of a spontaneous, emotional smile.
Information supported by the National Organization for Rare Disorders (NORD).
Early Intervention & Support
In infancy, the most urgent medical priorities for a child with Moebius syndrome are addressing feeding difficulties (due to poor lip seal and tongue movement) and protecting the corneas, as the child may sleep with their eyes open.
Reconstructive "smile surgery" is typically deferred until the child is between 4 and 6 years old, when they are large enough to safely undergo microvascular tissue transfer and old enough to participate in the necessary post-operative physical therapy.
Common Characteristics
Moebius syndrome presents differently in every patient, but common clinical signs include:
Facial Immobility
A "mask-like" lack of facial expression. Infants do not cry with a typical grimace, and children cannot smile or show emotion on their face.
Eye Movement Deficits
Due to 6th cranial nerve palsy, the patient cannot move their eyes outward past the midline. They must turn their head to track objects to the side.
Speech & Feeding Issues
Difficulty forming sounds that require the lips (B, M, P) and trouble swallowing or drinking from a straw due to weakness in the mouth and throat.
Smile Reanimation Surgery
Because the native facial nerves and facial muscles never developed properly, we cannot simply "repair" them. We must bring new muscle and a new nerve source into the face.
This is the gold standard for restoring a smile in Moebius syndrome. In a highly specialized microvascular surgery, Dr. Jowett transplants a small segment of the gracilis muscle (from the inner thigh) to the face. Because Moebius is bilateral, this surgery is typically done in two stages (one side of the face at a time, spaced several months apart). This procedure is central to Smile Reanimation.
Why Choose Revitalis?
Dr. Nate Jowett is a world-renowned expert in facial reanimation. With dual fellowship training in Germany and at Harvard Medical School, he brings a unique engineering and microsurgical background to treating complex facial nerve disorders.
Whether you are days into a diagnosis or have lived with incomplete recovery for years, Dr. Jowett offers the full spectrum of care, from medical management to cutting-edge surgical reconstruction, to help you regain your smile and confidence.
Selected References
- Bilateral Facial Paralysis: A 13-Year Experience. Banks CA, Jowett N, et al. Plast Reconstr Surg. 2017 Apr;139(4):971-980. doi: 10.1097/PRS.0000000000003180. PMID: 28121888.
- A General Approach to Facial Palsy. Jowett N. Otolaryngol Clin North Am. 2018 Dec;51(6):1019-1031. doi: 10.1016/j.otc.2018.07.002. PMID: 30119926.