What is Facial Synkinesis?

Facial Synkinesis is a condition that consists of involuntary, unwanted facial movements - usually as a result of incomplete recovery from previous facial nerve damage, also known as facial paralysis. Each case differs and varies depending on the degree of motor weakness and abnormal facial movements.

This condition acts as a tug-of-war match between competing facial muscles. The biggest challenge is trying to localize the muscle group that is causing the involuntary movements and teaching the patient effective inhibition techniques accompanied by the injection of Botox that paralyzes the muscles temporarily. Facial plastic surgeon Monica Tadros MD. specializes in facial synkinesis for her patients in NY & NJ.

Dr. Tadros accepts most POS and PPO insurance in NYC & NJ for any medical issues as an out-of-network provider. Please contact us today or call our center for cosmetic plastic surgery in NYC: (201) 408-5430 or NJ: (201) 408-5430

Facial Synkinesis Symptoms

Symptoms of facial paralysis only affect the side of the face that has been introduced to trauma in the past. Some common signs associated with this condition are:

  • Short tight muscles- affected muscles are overworked/short, stiff muscles form
  • Linked movements- more than the intended muscles move, over time become habitual
  • High tone in facial muscle- affected muscles work overtime, regardless of how relaxed they may feel
  • Poor movement sequencing- the body forget the natural order of habitual movements, resulting in the muscles canceling each other out or working all at once in bulk
  • Reduced coordination-muscles work all at once instead of performing their specific jobs
  • Abnormal muscle contractions- specifically of the eye, mouth, mid-face and neck
  • Hyperlacrimation- reproductive watering of the eyes

Facial synkinesis treatments for NJ patients aim to reduce involuntary activity while preserving muscle tone and function.

Facial Synkinesis In-Depth

by Monica Tadros, M.D., F.A.C.S.

Facial Synkinesis Treatment

Facial paralysis and involuntary movements do not always occur after facial trauma, however, it is quite common. When these problems are present, they range in severity, from mild to more serious cases that involve more intensive treatments. Physical therapy accompanied by targeted injections of Botox to the specific muscle group is highly recommended with much attention to facial muscle retraining. There are some cases in which synkinesis will persist despite prolonged treatment.

This problem does not always occur, but when present, it can be mild to severe. Physical therapy and targeted botox injections are still the preferred option in the treatment of synkinesis. However, in some instances, synkinesis may persist despite prolonged treatment. In cases in which the issues are interfering with your everyday life, surgery may be suggested to help relieve some of the problems that occur. The option of surgery may help disrupt the divergent neural pathways that are responsible for causing involuntary, unwanted facial movements.

In these cases, surgery may help disrupt the divergent neural pathways that are responsible.

Targeted Nerve Destruction (Neurolysis)

One of the most important factors that play a large role in effective surgical treatment of facial synkinesis is a firm understanding that the aberrant pathways of stimulation that occur in someone that is suffering from this condition is simultaneously recovering from a facial injury.

The pathways and muscle groups of the patient affected by facial paralysis can be better understood through initial treatments using selective injections of Botox. By identifying the nerve branches that are responsible for the movements, the doctor can more easily identify which area may undergo neurolysis more accurately. By identifying and stimulating the tiny branches involved, it is easier to target the problem area more precisely before diving their pathways.

Targeted Muscle Destruction (Myectomy)

In addition to neurolysis, destruction or targeted muscle release can aid in diminishing the involuntary, unwanted contraction or twitching. This technique requires the identification of the muscles that are being overworked before the surgery to possibly target them initially with botox injections.


Interested in learning more about facial synkinesis treatment in NYC & NJ? Please call experienced facial reanimation surgeon Dr. Monica Tadros at NYC: (201) 408-5430 or NJ: (201) 408-5430 to schedule your consultation.

Methods for facial palsy treatments vary from person to person, as every synkinesis patient is different. Typically, physical therapy is highly recommended for patients that are experiencing partial synkinesis or permanent synkinesis to help restore facial movement. Also, botox injections paired with physical therapy can help improve facial symmetry.

If the common treatments for this condition are ineffective, surgery may be the next best option. Dr. Monica Tadros has extensive experience in treating NJ patients suffering from synkinesis, both surgically and non-surgically.