Facial Synkinesis in Neptune and Holmdel, NJ

Facial synkinesis is a condition that can develop as the facial nerve recovers from paralysis or injury. It causes certain facial muscles to move involuntarily during normal expressions, such as smiling, blinking, or speaking. These unwanted movements can create facial tightness, asymmetry, and difficulty with everyday facial expressions.

At Coastal, we offer personalized treatment for facial synkinesis, including targeted neuromodulator injections (such as BOTOX®) to help relax overactive muscles, improve facial symmetry, and restore more natural, comfortable facial movement.

Facial synkinesis most commonly develops after an episode of facial paralysis, such as Bell's palsy, or following injury to the facial nerve.

As the facial nerve heals, some nerve fibers may reconnect to muscles other than their original targets. As a result, muscles that normally work independently may begin contracting together.

For example, someone with synkinesis may notice that their eye involuntarily closes when they smile, or that muscles around their mouth tighten when they blink.

Common symptoms include:

• Involuntary eye closure when smiling, speaking, or moving the mouth
• Facial tightness or stiffness, particularly in the cheek or around the eye
• An uneven or restricted smile caused by overactive facial muscles
• Involuntary chin dimpling or tightening around the mouth
• Neck tightness or visible neck muscle contractions during facial expressions
• Facial asymmetry, both at rest and during movement

Although facial movement may have returned after the original paralysis, these abnormal muscle contractions can make smiling, speaking, eating, and expressing emotions feel less natural.

One of the most effective nonsurgical treatments for facial synkinesis is the use of targeted neuromodulator injections, such as BOTOX®.

These medications temporarily reduce activity in selected facial muscles. By carefully relaxing muscles that contract excessively or at the wrong time, treatment can help restore a better balance between different areas of the face.

Unlike cosmetic BOTOX® treatments, which primarily aim to soften wrinkles, treatment for facial synkinesis focuses on improving facial movement, comfort, symmetry, and function.

Depending on your symptoms, injections may be used to:

• Reduce unwanted eye closure during smiling
• Relieve tightness and muscle spasms in the cheek or around the mouth
• Improve smile symmetry by relaxing muscles that restrict movement
• Reduce involuntary chin or neck contractions
• Improve facial balance at rest and during expression

The goal is not to eliminate facial expression or completely relax the affected side of the face. Instead, treatment is carefully tailored to reduce unwanted muscle activity while preserving natural movement.

Treatment begins with a detailed evaluation of your facial movements. Our facial plastic and reconstructive surgery team will assess how your face looks at rest and during expressions such as smiling, blinking, pursing your lips, and raising your eyebrows.

Because facial synkinesis affects each person differently, there is no single injection pattern that works for everyone.

Based on your examination and symptoms, small amounts of neuromodulator are injected into specific facial muscles using a fine needle.

Treatment is performed in the office and typically takes only a few minutes once the injection plan has been established. Most patients can return to their usual daily activities shortly afterward.

The effects generally begin developing over several days, with the full response becoming apparent within approximately two weeks. Results typically last around three months, although this varies between patients.

Follow-up visits allow us to assess your response and adjust treatment as needed. Finding the best balance may require adjustments over the first several treatment sessions.

For many patients, facial synkinesis can be frustrating because facial movement has returned, but the muscles no longer work together as they once did.

Targeted neuromodulator treatment can help reduce these unwanted contractions and improve the way the face feels and moves.

Potential benefits include:

• More balanced and natural facial expressions
• Improved smile symmetry
• Less involuntary eye narrowing or closure
• Reduced facial tightness and discomfort
• Better control of facial movements
• Improved confidence during everyday interactions

Treatment does not repair the underlying facial nerve injury or permanently eliminate synkinesis. However, it can provide meaningful improvement in symptoms and quality of life.

Facial synkinesis can affect more than appearance. Unwanted facial movements and persistent muscle tightness may interfere with smiling, eye closure, eating, and everyday communication.

At Coastal, Dr. Goldfarb provides individualized evaluation and treatment for patients with facial paralysis and synkinesis.

If you are experiencing facial tightness, asymmetry, or involuntary movements following Bell's palsy or another facial nerve injury, schedule a consultation at our Neptune or Holmdel, NJ office to learn whether neuromodulator treatment may help improve your facial movement and comfort.