Kimberly Williams-Paisley Was Awake During 3-Hour Surgery to Help Her Speak Again: 'It Was Bizarre' (Exclusive)

Kimberly Williams-Paisley was afraid she might never speak above a whisper again.

The Father of the Bride actress suddenly lost her voice in November 2022 and for more than a year, despite "looking in every corner and trying everything" she still couldn't speak loud enough to be heard at a dinner party, or on a red carpet — or by her two teen sons she shares with husband Brad Paisley when she tried calling them for dinner.

"So much of our personalities are expressed in our voice and for me, so much of my career," she says. "And when that's not there, I thought, 'Who am I?' I felt invisible," says Williams-Paisley, who is opening up about her ordeal for the first time in this week's PEOPLE cover story. "I'm someone who tries to find the silver lining no matter what, but there are days when I really grieved."

In January 2023, Williams-Paisley visited the Vanderbilt Voice Center, where doctors have treated some of the biggest names in Nashville, from Johnny Cash to Wynonna Judd. They put a scope through her nose and down her throat to examine her vocal cords, but the muscles in her neck were so tight that the cords were barely visible. She was diagnosed with muscle tension dysphonia.

"When we first saw her, it was hard to tell what was happening to the vocal cords themselves," says Dr. Gaelyn Garrett, executive medical director of the Voice Center.

Because doctors could not actually see the vocal cords to identify the problem, they had to address the voice strain due to the muscle tension first. "It's almost like you put a purse string around the tissue that sits right up above the vocal cords, and it's squeezing," Dr. Garrett says of the way the muscles were constraining her voice.

Related: Kimberly Williams-Paisley Opens Up About 'Terrifying' 2 Years She Couldn’t Speak: ‘I Felt Trapped in My Own Body’ (Exclusive)

The actress started physical therapy to reduce tension, including "a specific type of physical therapy approach using hands-on treatments, something akin to myofascial release," Garrett says. "You're working at pressure points and giving exercises to do at home to alter the muscle memory."

The actress also began a personal "deep dive" looking for anything that could help her alleviate stress, including going to a mental health therapist, seeking out a psychic and astrologer, trying hypnosis, cutting out food that could cause inflammation like gluten, sugar and dairy, and beginning a daily meditation practice (which she continues to this day).

A year later, she still couldn't speak above a whisper — but her hard work did pay off in another way. Doctors checked her vocal cords again and finally determined her underlying problem. Her left cord was weak and wasn't touching the right cord when they were vibrating, a condition known as partial paralysis. In Williams-Paisley's case, the condition may have been caused by a virus.

"You hope the therapy fixes the problem but sometimes you'll uncover an underlying problem that was not initially apparent, which is exactly what happened with Kimberly," Dr. Garrett says.

Her muscles had been tensing up to compensate for her vocal cord. "She had to exert a lot of force to try and bring her vocal cords together because of the weak left vocal cord," says Vanderbilt speech pathologist Jennifer Muckala, who worked with Williams Paisley. "She was essentially a leaking valve."

To determine if surgery would help her, Garrett says, her medical team injected a filler (hyaluronic acid —"the same filler that people use cosmetically") into her left cord to see if bulking it up would help her speak. "It was a trial to see if we got the vocal cords to close better and vibrate more symmetrically, would that provide her the benefit she needed to improve her voice quality," Garrett says,

The filler worked, so Garrett decided Williams-Paisley was a candidate for medialization laryngoplasty, a procedure in which the weak left vocal cord is moved closer to the right. The actress underwent the three-hour surgery in August — and all the while she remained awake.

“We wanted to tune the cord the best we could,” says Garrett, who along with a team at Vanderbilt performed the surgery. She says she averages one of the procedures per week. “We had her awake so we could hear how the voice changes as we manipulated the position of the vocal cord. We’re trying to get the natural voice back.”

Being awake as they opened up her throat was “bizarre” Williams-Paisley says. “They put up aplastic sheet so I couldn’t see anything except my throat on a screen they set up. It looked like another mouth, like a big hole!"

But, she says, going in with her eyes open was “beautifully symbolic. I feel like I’ve been waking up to myself. I had to be fully present to cross this finish line, and I was really ready for it."

During the procedure, the team took an implant made of silicone rubber and put it next to her left vocal cord to hold it in place, then asked her to speak. They removed it, adjusted the size by hand-carving it, replaced it and had her try again. When her voice was back to its natural tone, they knew it fit perfectly. And once in place, the implant — which is permanent and should last a lifetime — allowed her to speak out loud again for the first time in nearly two years: “I couldn’t believe it was true,” she says. "It felt great."

Her resulting neck scar was significant (although the doctor made sure to cut into a neck wrinkle —"Fortunately for me, I have wrinkles!" she jokes). For a few months she needed to protect the scar from the sun by wearing scarves, but now “I’m not self-conscious about it. I’m proud. It’s part of my story.”

Now that she's on the other side of her surgery, Williams-Paisley works to keep her voice healthy by meditating daily to help reduce stress and performing vocal exercises. She also leans on a tool that speech pathologist Muckala suggested: a hollow plastic swan that she can speak into and hear her voice sound loud and strong as if singing in the shower.

"After surgery, her vocal folds can now touch and she can exert force with her breath without it closing off, but there is a challenge in hearing yourself well," says Muckala. "Kim is a really dynamic and really emotive person and the voice limitation got in the way of that."

Her swan exercises let her know that her voice will be there. "It's a way of anchoring her to her competence," Muckala says.

Today, Williams-Paisley says her voice is ready to project again — and she's even taken on her first professional job post-surgery, hosting Fox's next season of Farmer Wants a Wife, premiering March 20. And even though her voice has changed, "I love and appreciate it no matter what form it takes. I know my voice is doing the best it can."

Read the original article on People