Recognized International Facial Paralysis Surgeon in Dallas, Texas
Shai M. Rozen, M.D., is a Professor and Vice Chair of Plastic and Reconstructive Surgery in Dallas, Texas, where he also serves as Director of the Facial Reanimation Program, the Microsurgery Fellowship, and Clinical Research. He is a board-certified plastic and reconstructive surgeon specializing in facial paralysis surgery (facial reanimation); facial cosmetic surgery, including facelift surgery; and rhinoplasty (nose surgery) in Dallas, Texas.
"The principles of both reconstructive and cosmetic surgery go hand in hand and greatly benefit my patients. I apply aesthetic principles in all of my reconstructive patients and perform cosmetic surgery in areas of the body in which I have performed complex reconstruction," Dr. Rozen says.
Facial Paralysis and Facial Reanimation in Dallas, Texas
Dr. Rozen has trained extensively in craniofacial reconstruction and microsurgery, enabling him to address both bony and soft tissue problems in the face. As Director and founder of the Facial Reanimation Program at UT Southwestern, he works with colleagues in otolaryngology, neurosurgery, neurology, and physical medicine and rehabilitation to address in one clinical and multidisciplinary setting the complex problem of patients with paralyzed faces.
"Facial paralysis patients can be divided into two groups: patients with flaccid facial paralysis and patients with synkinesis. Patients with flaccid facial paralysis suffer from a very weak face with no motion and are frequently droopy. They cannot close their eyes, are unable to smile, often drool from the mouth, and frequently complain of speech difficulty. Patients with synkinesis usually have had a previous flaccid phase and have partially recovered but not in a normal way. The face starts to become tightened, often pulling to the paralyzed-synkinetic side. Patients will complain of blepharospasm (tight eyelids), excessive tearing, facial tightness without the ability to smile, biting of the lip or cheek, and often neck tightness."
The cause of facial paralysis can vary significantly among patients. Usually, one underlying cause can lead to both flaccid facial paralysis and synkinesis, depending on the degree of recovery of the facial nerve. Common causes include Bell's palsy, Ramsay Hunt syndrome, acoustic neuroma surgery, cancer, and surgery for cancer. In some cases, it can be caused by face lift surgery.
"Regardless of the cause of paralysis, both groups of patients are devastated and are unique in their treatment strategy,” Dr. Rozen says. “In patients with flaccid facial paralysis, the timing of surgery is crucial. If patients present early enough, we can treat them with nerve transfers, nerve grafts, and cross-facial nerve grafts. If patients present after 18 months or so, the muscle of the face often cannot be recovered, and we must transplant muscle with their nerves and blood supply into the face to restore some of the motion and function that has been lost."
Conversely, for patients with synkinesis, the treatment strategy differs, with the primary goals defined as rebalancing the face by weakening muscles that are too strong (spastic) and strengthening others. This is done by selective neurectomies and selective myectomies.
"I am thankful for the great multidisciplinary facial paralysis team that formed over the years, enabling us to achieve a very high level of care, which exists in very few places in the country and enables patients to be seen expediently by the best specialists in a short period. I truly enjoy helping patients with facial paralysis to the best of my ability, and together with my patients and other physicians, we work hard at constantly improving the science and art of taking care of facial paralysis patients," Dr. Rozen says. "At the end of the day, my goal with my patients is for them to be happy and satisfied about how they look and function."
Facial Cosmetic Surgery in Dallas, Texas
In his cosmetic surgery practice, Dr. Rozen focuses on the face. At the core of this specialty is the marriage of reconstructive and aesthetic surgery. According to Dr. Rozen, both reconstructive and cosmetic surgery must look good, work well, and be safe.
"My aesthetic facial practice was a natural evolution of my experience from treating difficult and complex cases of facial paralysis. The goal with every facial palsy patient is to restore not only function but also aesthetics. Additionally, many of my facial paralysis patients asked for additional facial aesthetic procedures, which always complement our results. The surgical and anatomical experience gained from performing several thousand complex facial microsurgical paralysis procedures and subsequent facial cosmetic procedures allowed me to hone the skills in both more routine facial cosmetic cases such as face lifts, eyelid surgery, and nose surgery as well as treat complications of such procedures performed elsewhere."
Similar to facial paralysis patients, each facial cosmetic patient is unique. There are many techniques for performing face lifts, and often different methods will fit various individuals. Dr. Rozen provides face lift procedures that fit each patient, whether it be a bi-lamellar high SMAS (superficial musculoaponeurotic system) face lift, a composite face lift, deep plane face lift, or any other variation needed to help provide optimal results.
The same guiding principles apply to surgery of the eyelids and nose.
Most patients are good candidates for simple blepharoplasty, which involves removing excess skin from their eyelids. However, some will need more intricate surgeries to support the eyelids, such as canthoplasty or tarsal strips, or more complex upper eyelid surgeries similar to those Dr. Rozen performs for reconstructive eye surgery.
Similarly, nasal surgery is often performed for both aesthetic and functional reasons. The intricacies of nasal surgery are significant. To obtain good functional and aesthetic results, significant attention to detail is needed, and results must fit the overall facial appearance of the face.
Dr. Rozen is the principal investigator for several large-scale studies and has received several prestigious awards and grants for his work. He collaborates in research with colleagues worldwide and regularly presents nationally and internationally as a guest speaker in leading academic centers in the United States, Europe, Asia, and South America, in major clinical and scientific conferences and courses for other physicians.
In addition, Dr. Rozen immensely enjoys teaching and working with his residents, fellows, and medical students.
"It is always amazing to see how my residents develop their clinical and surgical skills over the years, but to be honest, I constantly learn from them – from their questions, challenges, or sheer curiosity. Training future physicians and colleagues is a great honor and privilege."