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This article outlines a thorough approach to facial nerve palsy and reconstruction.

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Facial palsy inflicts significant morbidity, and treatment aims to address functional, aesthetic, and psychological aspects. The facial nerve is responsible for providing the facial tone and movement necessary for ocular protection, nasal airflow, articulation of speech, and oral continence. Furthermore, psychosocial functioning of the individual is greatly influenced by the activity of the mimetic musculature. Patients with facial palsy may be perceived as “different” and face discrimination socially and in the workplace; such issues can lead to social withdrawal. Indeed, psychological stress rather than functional deficit has been determined to be a critical factor in predicting social handicap 1 and reason for surgery. 2