Recent advances in clinical and surgical techniques have introduced novel approaches for managing idiopathic peripheral facial palsy (IPFP) and its complications, such as facial synkinesis. Patients with unresolved IPFP struggle with long-term facial muscular dysfunction, aesthetic changes, and psychosocial turmoil that deeply impact their quality of life (QoL). Heterogeneous data that once undermined consensus in management has sparked new innovations, advancing our understanding of facial nerve dysfunction, and fostering surgical refinements that offer durable functional and aesthetic outcomes. The goal of this chapter is to provide foundational knowledge which underscores successful clinical management of IPFP, including surgical techniques designed to treat facial paralysis and facial synkinesis.