Facial Paralysis (Bell’s Palsy)

Functional oculoplastic surgery focuses on the eyelids, eye sockets and facial structures around the eye area. It’s a highly specialised surgical procedure combining ophthalmology and plastic surgery. The surgeries are also delicate and involve operating on incredibly fine structures.


Paralysis or loss of strength or motor function of the muscles that control facial expression can result in a sudden inability to close the eyes or blink effectively.

This can cause severe disability and when inadequately managed, can lead to a significant risk to vision.

How is facial paralysis treated?

In the initial stages, close clinical monitoring is essential, accompanied by a comprehensive regimen of medications such as eye drops and creams. Additionally, a series of exercises and protective measures contribute to effective acute management.

Fortunately, the majority of facial nerve paralysis is temporary. Following thorough investigations and scans, a non-invasive management approach is adopted until the affected eye muscles regain their strength and function.

Bell’s Palsy, often the culprit behind this facial nerve paralysis, is a self-limiting condition. Treatment involves the use of steroids and, in some cases, antiviral tablets. It is crucial for your doctor to initiate this treatment promptly upon a patient’s presentation with facial paralysis. However, a final diagnosis of Bell’s Palsy should not be conclusively made without an appropriate referral to hospital specialists.

This precaution is necessary to rule out less common but more serious causes of facial paralysis, such as infections, tumours, trauma, recent surgery, or vascular events, each requiring distinct treatment strategies and possibly resulting in a slower resolution or permanent muscle strength loss.

When is oculoplastic surgery necessary for treating facial paralysis?

Instances where there is permanent weakening or complete paralysis of the muscles surrounding the eye, cheek, and eyebrow require intricate oculoplastic surgery procedures. These procedures aim to optimise both the function and appearance of the affected area.

The goals include enhancing the natural blink and eyelid closure to protect the eye, repositioning the eyelid and eyebrow anatomically, addressing ocular dryness or tearing, and restoring symmetry.

Treatment plans are individualised and may, at times, require a staged approach for the best possible outcome.

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.