Synkinesis - unwanted facial movements.

Chemodenervation

Botox and related compounds are used to relax the muscles. We can rebalance the muscles to improve the tightness sensation and improve the appearance. It can often improve random episodic tearing of the eye.  

The injections are done in a somewhat different pattern to the standard aesthetic use.

Selective myectomy

Some muscles are so overactive that they are better treated through releasing and removing a part of the muscle.  Most commonly the depressor anguli oris is removed.  This can be done under local anaesthetic.  This rebalances the smile so that lip does not inadvertently turn the corner down.  Every patient is different and the assessment is individualised.

It is an adjunct to chemodenervation rather than replacement.

Selective neuroectomy

This is a sophisticated and complex surgery.  The nerve branches are explored and individually stimulated. We find the branch creating the unwanted movement and cut it.  It is a delicate balancing act between preserving the normal branches and removing the abnormal ones.

This can significantly reduce the amount of chemodenervation required. It can be combined with selective myectomy as well.

Combination treatment

Many of the facial nerve treatments are done in combination. However, everyones face is unique and the conditions affect if differently. Therefore although we have given an overview, it is very dependent on your individual needs.