Facial paralysis or synkinesis may occur when there is damage to the facial nerve. Paralysis can cause one or both sides of the face to droop, become unable to move, or be weakened. Synkinesis can cause one side of the face to become too tight and can cause unwanted facial movements or spasms.
BOTOX® can help with facial paralysis or synkinesis by blocking nerve activity to certain muscles. Filler can be injected to camouflage some of the effects of facial paralysis or synkinesis.
BOTOX® and filler therapy are two treatment options for facial nerve damage.
Facial paralysis can occur for several reasons. You may be born with the condition, or you may develop it because of:
No matter the reason you develop facial paralysis or synkinesis, the experience can be emotionally and physically difficult. These conditions can lead to obvious facial asymmetries or functional issues like eye irritation, drooling, or speech issues.
BOTOX® and filler therapy can help treat some of these symptoms.
Using BOTOX® to help alleviate symptoms of facial nerve damage is quite popular. It is one of the most common treatment options for this condition. Dermal fillers are also becoming more common as an alternative to other surgical options.
BOTOX® is a medication that blocks nerve activity to certain muscles. It is injected into desired muscle groups to relax them, which can relieve some bothersome symptoms of synkinesis, such as:
In patients with flaccid facial paralysis, BOTOX® can be injected into the unaffected side to help achieve better facial symmetry.
Dermal fillers are minimally invasive injections that are meant to rejuvenate parts of the skin. If your face is aging asymmetrically after facial paralysis, fillers can help mask these asymmetries and be used as “space occupiers” to fill in facial areas with insufficient volume.
Injections can be made of synthetic or natural materials. Talk with your surgeon about which filler option is right for you.
There are several dermal fillers on the market today, and each has its advantages and disadvantages. The best option for you will depend upon your personal needs, age, goals, and lifestyle.
BOTOX® and dermal fillers for facial nerve damage can help people with facial paralysis enjoy a more symmetrical or “filled-out” facial look. This can also help boost people’s confidence in social settings and help them feel more like themselves after facial nerve damage.
Find a safe, reliable, licensed professional to perform your procedure. Talk with your facial plastic surgeon or other care team members about your eligibility for these treatments before scheduling a procedure.
Complications from BOTOX® injections may include:
Complications from dermal fillers include:
Before deciding on a treatment method, you can expect a consultation visit with your facial plastic surgeon. They will help develop a personalized treatment plan and review your facial function and areas of concern to develop a preliminary injection pattern. Both treatment methods can be done at a facial plastic surgeon’s office and do not require a hospital visit.
There are no special preparations for a BOTOX® injection, and anesthesia usually is not necessary.
During a BOTOX® procedure, a thin needle injects small amounts of botulinum toxin into one of the 43 muscles in your face. Depending on the area(s) being treated and the severity of facial nerve damage, each area can take one to five or more injections in a single setting.
Your health care provider will take their time to ensure they are choosing the correct facial muscles to relax, depending on your preliminary injection pattern and symptoms.
After injection, you may experience bruising at the sites. This should fade in three to seven days. You may want to look over the list of tips to minimize bruising.
It is important to rub or massage the treated area(s) for at least four hours after the treatment. Because there is no extensive recovery time following a procedure, BOTOX® is often referred to as the “lunch hour facelift.”
You may start to see BOTOX® results three to five days after injection, but final results set in around two weeks.
The injections typically last for three to four months. You may schedule future injections. The pattern of injections may be altered depending on the success rate and your personal feedback.
Your facial plastic surgeon will first perform a detailed analysis of your face and health history to determine your eligibility. You should speak with your prescribing physician regarding the use of blood thinners. These medications can cause bruising and swelling.
In the office, the part of your body receiving the filler will be numbed with topical agents and local anesthesia. Your surgeon may also want to inject a nerve-blocking agent to better numb a specific area of your face.
Once the area is numb, the various fillers will be placed into the areas that you want rejuvenated through small needles. The procedure usually takes 30 to 45 minutes.
Most patients can go out in public that day, although some bruising and swelling of the area is possible. You should be able to return to work the next day. Rarely, people experience more significant swelling that takes a couple of days to subside.
Results from filler therapy typically last for a year. Patients may want to have periodic touch-ups.
If you are suffering from facial nerve damage and don’t have other underlying health conditions, you may be a good candidate for BOTOX® or dermal fillers to treat your facial paralysis symptoms.
Talk with your primary care doctor or a facial plastic surgeon about your options.
Depending on your insurance coverage, BOTOX® may be covered for the treatment of facial paralysis, synkinesis, and hemifacial spasm. If your insurance company does not cover this treatment, you can expect to pay up to $500 for each injection session. These costs vary depending on the location of services, the amount of product needed, and the severity of the areas being treated.
Unfortunately, dermal fillers are not covered by most insurance plans. The cost of filler therapy depends on the amount of product needed and the nature of the treatment.
BOTOX® and dermal fillers can help relieve symptoms of facial nerve damage. Results from BOTOX injections typically last for three to four months. Your provider may adjust your injection pattern at future appointments based on your initial results and feedback.
Results from dermal fillers typically last up to a year.
By UPMC Editorial Staff. Last reviewed on 2026-03-01.
