UVA Facial Nerve Center multidisciplinary team (left to right) front row: Casey Cavanaugh, PhD; Katherine Fedder, MD; Vusala Snyder, MD; Sam Oyer, MD; Nancy Vilar, MD. Back row: Jaclyn Shepard, PsyD; Stephen Park; MD; Ben Lovin, MD; Bert Jun MD; Brad Kesser, MD; Jim Gigantelli, MD
The UVA Facial Nerve Center is a multidisciplinary clinical team started in 2025 by Samuel Oyer, MD, associate professor in the Department of Otolaryngology and director of the Division of Facial Plastic Surgery and Reconstructive Surgery. The center brings together a diverse group of specialists from across the School of Medicine to evaluate and treat patients with facial paralysis.
Dr. Oyer and his team are dedicated to helping patients present their best and most natural face to the world. “Having an opportunity to improve a person’s facial function and help them participate more fully in their daily life, from both a physical and social aspect, is an incredible challenge, yet such an immensely rewarding honor,” said Dr. Oyer.
In this second installment of our Medicine in Motion series highlighting faculty who lead multidisciplinary teams, we spoke with Dr. Oyer about his work treating facial nerve paralysis and the importance of collaborating with other experts to create individualized plans for each patient’s unique circumstances.
Why did you start this program and who are the key faculty involved?
Oyer: This center was developed to coordinate the high-level facial nerve treatment that is already occurring at UVA Health. I’m a facial plastic surgeon with experience and training in facial reanimation surgery. I serve as the director of the center with Vusala Snyder, MD, also a facial plastic surgeon, serving as co-director. There are 18 faculty members overall including faculty from the Departments of Neurosurgery, Otolaryngology, Neurology, Ophthalmology, and Emergency Medicine. Unique to this center is the subspecialized care of Helen Gatling-Austin, PT, a physical therapist who performs facial neuromuscular retraining, and our mental health team Casey Cavanaugh, PhD, and Jaclyn Shepard, PsyD, who help patients with the mental health challenges that are commonly associated with facial nerve disorders.
Why is a multidisciplinary approach to this disease needed?
Oyer: Facial paralysis occurs from a variety of causes and carries a wide range of functional and psychosocial impacts for many patients. Multi-specialty care is critical to provide complete treatment for the entire patient. Some team members’ expertise is critical for the initial management or testing needed to properly diagnose the facial nerve disorder. Other specialists are integral for surgical management of tumors or other conditions causing the paralysis, while others provide reanimation surgery to help restore motion to areas of paralysis. Surgical and medical care is supported by ongoing therapy, both physical and mental, to help patients reach their full recovery potential.
What excited you about offering a specialized approach?
Oyer: The impacts of facial paralysis are so intensely personal and threaten to impact a patient’s very identity, not to mention the ability to communicate and participate with society. Having an opportunity to improve a person’s facial function and help them participate more fully in their daily life, from both a physical and social aspect, is an incredible challenge, yet such an immensely rewarding honor. The opportunity to see someone smile for the first time and witness firsthand the doors that can open for them is such a blessing.
Can you share a success story about specialized care that was provided through your clinic?
Oyer: A patient was referred to me for facial paralysis that was attributed to Bell’s palsy but had no recovery for four years. He was left with a completely droopy face on one side, incomplete eye closure, nasal obstruction, and no smile on that side of his face. I, along with other members of the team, determined the cause of his paralysis to be related to a small hemangioma of the facial nerve, rather than Bell’s palsy. He underwent a gracilis muscle transfer surgery where a small muscle slip was removed from his leg and transferred to his face to replace the non-functional smile muscles. This was connected to blood vessels in his neck and the masseter nerve in his cheek to provide blood flow and nerve input to the muscle. After a period of recovery and facial rehabilitation with our PT, he is now able to achieve a nearly symmetric smile and close his eye completely. He returned to his life with a totally new outlook and confidence that he didn’t have when I first met him.
We’ve had similar success stories for children born with facial paralysis who were never able to smile on one or both sides of their face. To see a child smile for the first time, and see their parents’ reaction to this, is truly inspirational!
What makes your team special?
Oyer: Our team is led by facial plastic surgeons with specialized training and experience in all areas of facial paralysis treatment including minimally invasive in-office procedures to complex microvascular reconstruction. We offer the full spectrum of facial reanimation medical and surgical treatments and perform research in this area to improve patient outcomes. This is coupled with a specially trained physical therapist who has extensive expertise in facial retraining to help improve facial function during recovery or following surgery. The team is rounded out by expert medical and surgical specialists that cover all areas of facial nerve treatment, from acute management and nerve testing studies to advanced ophthalmologic care with corneal neurotization, neurosurgical and skull base care, and mental health support to treat all aspects of facial paralysis.
In the group photo, UVA Facial Nerve Center multidisciplinary clinical team members not pictured include Helen Gatling-Austin, PT, Physical Therapy; Cameron Grimes, PT, Physical Therapy; Ashok Asthagiri, MD, Neurosurgery; Matthew Elliott, MD, Neurology; Alex Elias, MD, Neurology; Brit Long, MD, Emergency Medicine; and Sarah Wendel, MD, Emergency Medicine.