Abstract
This article will describe facial asymmetry secondary to facial nerve paralysis (FNP),
and review current concepts, guidelines, and future trends. Despite the increasing
use of botulinum toxin (BoNTA) in treating FNP, ideal dosage, timing, and additional
therapies are not unequivocally established. Facial asymmetry significantly impacts
quality of life (QOL) by strongly affecting self-perception and social interactions;
injectables may mediate great clinical improvement. This article provides practical
guidelines for the use of BoNTA and provides schemes for accurate assessment and documentation.
A systematic, stepwise approach is recommended with methodical assessment, meticulous
placement, conservative dosage, and careful follow-up. Future trends include the potential
use of newly developed toxins, muscle modification with fillers, improved imaging
techniques, and targeted QOL studies. Hopefully, a growing number of aesthetic injectors
may become technically proficient and join multidisciplinary teams for managing FNP.
Keywords
Bell’s palsy - facial asymmetry - facial nerve paralysis - onabotulinum toxin A -
quality of life
