Treatment of Facial Asymmetry with Botulinum Toxin

Facial asymmetry is an almost universal feature, but can also be a manifestation of numerous conditions that affect all of the anatomical facial planes. Asymmetry attributed to imbalance of muscle activity can often be targeted with chemodenervation with botulinum toxin. A major cause of significant facial asymmetry is facial nerve palsy and its consequences. The asymmetry arising from facial nerve palsy is not just the result of the paresis of the affected side. This is also magnified by contralateral hyperkinesis and synkinesis. Managing the asymmetry arising from facial nerve palsy requires a multidisciplinary approach, often starting with physical therapy and including, where necessary, botulinum toxin injections which can offer significant benefits.