Full Face and Neck Treatment With OnabotulinumtoxinA in Patients With Facial Palsy

May 2021 | Volume 20 | Issue 5 | Features | 560 | Copyright © May 2021

Published online April 12, 2021

Roberta D’Emilio MD, Teresa Salerno MD, Giuseppe Rosati MD

Villa Salaria, Rome, Italy

middle third of the face. In palsy cases, one side of the face has no active elevator muscles. Hence, it is even more important to reduce platysma activity, in order to rebalance asymmetric tissue descent.


Use of BoNTA across the whole face and neck is a minimally invasive approach to the aesthetic treatment of facial palsy with a low risk of major complications and the potential for excellent results. When treating these patients, it is essential to find a balance between the relaxing effects of BoNTA and preservation of residual motor function. If treatment is performed gradually by a skilled practitioner, an acceptable compromise between aesthetics and function can be achieved.

In the two cases described here, we have demonstrated marked improvements in synkinesis, hyperkinesis and facial symmetry, and also shown an anti-aging effect similar to that achieved with normal full-face treatments using BoNTA.8 Results stabilized across multiple sessions of repeat treatment.


The authors declare no potential conflicts of interest with respect to the research, authorship, and publication of this article.


Writing and editorial assistance was provided to the authors by Timothy Ryder, DPhil, of Biological Communications Limited (London, United Kingdom) and funded by Allergan plc (now AbbVie) at the request of the investigator.


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Roberta D'Emilio MD demilioroberta@gmail.com