What is Facial Synkinesis and How to Find the Right Treatment For It

What is Facial Synkinesis and How to Find the Right Treatment For It

How would you feel if you encountered unwanted and unintended movement of your face while you smile? It is how a patient suffering Facial Synkinesis has to go through.

Around 30% of people who have had Bell Palsy or facial paralysis have an incomplete or delayed recovery. 

Synkinesis is not outright facial paralysis, but it affects most people who have experienced facial paralysis. They usually end up with a mismatch of a movement of the face and can even lead to social isolation.

However, with the advancement in science, there has been an impressive development in treating this disorder. From facial retraining exercises, there is a multitude of rehabilitation practices on the treatment ladder.

Read along to know more about synkinesis and its timely diagnosis.

What is Facial Synkinesis?

Synkinesis involves unintentional motion of one area of the face produced during the intentional movement of another. It can be troublesome for many since it is an unwanted movement that can interrupt primary to complex activity.

For example, people with synkinesis may be concerned about smiling without their eyes' forceful closure. It involves midfacial movement or reflexive eye closure even when not intended.

Cross-wiring the nerves during an injury or trauma can result in the nerves targeting the wrong facial muscles. Hence, synkinesis is not limited to one part of the face but multiple regions like the eyes, neck, mouth.  

Furthermore, it can limit primary activities like drinking, eating, smiling, etc. So, how do you recognize you have synkinesis? Synkinesis affects patients differently. The stringency of the symptoms can vary from one to another.

  • Muscle tension in the neck and facial twitching
  • Patients may experience involuntary muscle movements within 2-3 months of recovery from paralysis.
  • A synkinesis patient may also confront tenderness and pain in some regions of the face, even without the movement.

What are the Types of Synkinesis?

Here are a few commonly observed types of synkinesis that affect most face paralysis patients.

  • Ocular oral: In this type, a patient may undergo an involuntary movement of the corner of the mouth while raising eyebrows or closing the eyes.
  • Oral ocular: This can affect the eyes while the patient has oral movement. The affected eye fully or partially closes while they smile or chew.
  • Platysma: It affects the neck and mouth muscles. While moving the mouth, the neck muscles on the affected area may tighten and pull it down. As a result, it hampers with the smile of a person.
  • Midfacial: A synkinesis patient may experience pain or discomfort in the cheek area. It can happen even without any eye or mouth motion.
  • Mentalis: The chin creates a dimpling sensation in the affected area during a mouth or eye movement.

Right Treatment for Synkinesis

Facial Synkinesis ranges from benign to severe symptoms and impacts each person differently. Few patients healing from facial paralysis like Bell Palsy may gradually recover and not require further treatment.

However, few may need medical assistance to get back the balance of their facial movements and muscle activity.

There are selective options and diagnoses, from less invasive techniques like muscle training and facial therapy to invasive surgeries.

Physiotherapy and Facial Retraining

Before jumping onto a surgery, experts today recommend facial therapy to regain facial movement. Patients recently diagnosed with facial paralysis can kick-start with facial exercises within the comforts of their home.

Following this, with the help of neuromuscular retraining, facial gestures and expressions can get enhanced in no time.

Additionally, doctors also involve targeted exercises and personalized therapy based on the severeness of the facial dysfunction.

Botulinum Toxin

If the unwanted facial movement does not respond to retraining, then targeted botulinum toxin injections can help ease the spasm.

These targeted injections have temporary effects and need to be repeated every 4-5 months.

Facelift/Browlift (Refinement Procedures)

This treatment has proved beneficial for patients with droopy eyebrows and mismatched facial symmetry.

Hyaluronic acid fillers can help patients for a temporary period when they experience facial weakness due to synkinesis.

Surgical Procedures

Since botulinum toxins offer momentary results, surgery can be the next effective option for extended-lasting benefits. 

Also known as myectomy, these facial procedures can help correct the disheveled facial movement for acute facial paralysis or synkinesis.

Surgical intervention is generally recommended for patients who have encountered severe nerve injury. The acute trauma amplifies the chances of synkinesis affecting a patient's facial tone, movements, and symmetry.


Synkinesis is one of the unwanted after-effects of facial paralysis. It has resulted in interfering with the usual muscle functioning of the face for a prolonged period.

However, with careful examination and early detection, this muscular deformity has shown successful recovery through rehabilitation and surgical approach.