Joshua D. Rosenberg, MD, Assistant Professor of Otolaryngology at Icahn School of Medicine at Mount Sinai, is one of only a handful of U.S. surgeons who is using an innovative new procedure to restore the ability to smile in patients with facial paralysis.

The procedure, called cranial nerve V and VII transfer, helps to ameliorate the disfiguring effects of severe Bell’s palsy and, to a lesser extent, certain head and neck cancers. It calls for the surgeon to reroute the patient’s robust masseter nerve—which activates the chewing muscles—in order to power the paralyzed facial nerves and restore facial muscle function, specifically the muscles involved in smiling.

Approximately 40,000 Americans experience Bell’s palsy each year, which often paralyzes one side of the face. Scientists believe Bell’s palsy stems from a viral infection or a common cold sore that causes the facial nerves to become swollen and inflamed. Within a few months, many individuals recover completely and spontaneously. But for those who do not and are unable to smile again, the results can be devastating without surgery.

“Smiling is a universal form of human communication, and it affects our emotional state,” says Dr. Rosenberg, who is also a founding member of the Mount Sinai Health System’s Facial Nerve Paralysis Program. “When patients lose this ability to communicate, they are losing a basic human function. It is harder to feel engaged with others.”

The new approach improves upon alternative techniques by delivering quicker and more effective results. It allows direct innervation of the facial nerve branches involved in smiling. Regeneration occurs over a period of six to twelve months, restoring the patient’s ability to smile, eat, and speak.

With the new cranial nerve transfer, the surgeon makes a very small incision near the front of the ear and then sews together the facial nerve and masseter nerve, which are in close proximity to each other. According to Dr. Rosenberg, the results have been promising and no side effects have been reported. Due to the limited number of surgeons currently performing the procedure, he says patients have come to Mount Sinai from across the Northeast.

Rachel Lewis, a special education teacher from Chester County, Pa., who lost the use of the left side of her face to Bell’s palsy three years ago, is beginning to see improvement following the surgery she had at The Mount Sinai Hospital in December. “This surgery has given me a sense of hope—something I haven’t felt in years,” she says. “Dr. Rosenberg gives me honest and straight answers, but he also provides me with that comfort factor. I always come to office visits with a long list of questions, which he takes as much time as needed to answer.”