Synkinesis Treatments

Synkinesis causes uncontrolled facial movements during voluntary facial movements. For example, when a patient attempts to smile, the corner of the mouth may pull downwards, essentially freezing the smile on the affected side. In addition, synkinesis creates excess power (hypertonicity) in certain areas of the face and weakness (hypotonicity) in others. The face can be affected while at rest and in motion.

Dr. Shai Rozen is the Director of Microsurgery and Facial Palsy Program at the University of Texas Southwestern Medical Center in Dallas, TX, where he works alongside leading neurosurgeons and neurotologists. He and his team have the breadth of expertise needed to provide comprehensive treatment to these complex problems. They have helped many children and adults of all ages improve their facial function, harmony, and self-confidence.

Facial Paralysis Surgeon

Dr. Shai Rozen

Dr. Rozen is a board-certified plastic surgeon who co-created a facial paralysis specialty group with colleagues from otolaryngology & neurosurgery at the University of Texas Southwestern Medical Center. He has performed surgery for more than 3,000 facial paralysis patients and serves as the Director of the Microsurgery and Facial Palsy Program at UT Southwestern.

Meet Dr. Rozen

Credentials You Can Trust

What causes facial synkinesis?

Synkinesis is usually caused by the abnormal recovery of the facial nerve after injury from different reasons such as Bell’s palsy, tumor removal, trauma, infection, or any other type of facial nerve injury. Some patients with facial paralysis experience improved function early after the event and feel fairly symmetric approximately 6 months after their paralysis began. They then start experiencing a sense of increasing tightness in the face and uncoordinated facial motion—all symptoms of synkinesis.

Selective Myectomies for Synkinesis
 Before & After Photos

Case: 1 of 9

Previous Next

Before and 5 months after selective neurectomies of the facial nerve and myectomies

PreviousNext

Case: 1 of 8

Case #24

Smile and lower lip restoration in a patient with synkinesis with a combination of selective neurectomies and myectomy of the lower lip, performed by Dr. Shai Rozen in Dallas, Texas. Patient presented 6 months after an event of facial paralysis which was diagnosed as Ramsay Hunt Syndrome. She had difficulty with speech, eating, drooling, smil... Read More

Before and after selective neurectomies and myecotmy for synkinesis treatment

PreviousNext

Case: 2 of 8

Case #29

Smile and lower lip restoration in a patient with synkinesis with a combination of selective neurectomies and myectomy of the lower lip, performed by Dr. Shai Rozen in Dallas, Texas. Patient presented 15 months after an event of facial paralysis which was diagnosed as Bell's Palsy and evolved from flaccid facial paralysis to synkinesis. She h... Read More

Before and 3 months after a lower lip myectomy.

PreviousNext

Case: 3 of 8

Case #7

Smile restoration with a lower lip muscle myectomy performed by Dr. Shai Rozen in Dallas, Texas to restore smile and facial symmetry in addition to Botox®️around the left eye for her blepharospasm and neck for neck tightness secondary to underlying synkinesis. She presented several years after a bout of facial paralysis due to Bell's... Read More

Before and 2 months after lower lip myectomy.

PreviousNext

Case: 4 of 8

Case #12

Smile restoration with a lower lip muscle and buccinator myectomies performed by Dr. Shai Rozen in Dallas, Texas to restore smile and facial symmetry in addition to Botox®️around the right eye for her blepharospasm secondary to underlying synkinesis. She presented 4 years after an event of Bell's Palsy on the right side of the face a... Read More

PreviousNext

Case: 5 of 8

Case #25

Smile and lower lip restoration in a patient with synkinesis with a combination of selective neurectomies and myectomies performed by Dr. Shai Rozen in Dallas, Texas. Patient presented 4 years after an even of facial paralysis that was diagnosed as Bell's Palsy. He had difficulty with smiling, eating, speech, drooling,  biting of the lip... Read More

Before and after lower lip myectomy combined later with selective neurectomies.

PreviousNext

Case: 6 of 8

Case #27

Smile restoration and improved lower lip position, oral function, and facial balance with selective neurectomies, performed by Dr. Shai Rozen in Dallas, Texas in addition to Botox®️around the right eye for her blepharospasm secondary to underlying synkinesis. She presented a year  after removal of an acoustic neuroma, initially with flacc... Read More

Before and 4 months after a lower lip myectomy.

PreviousNext

Case: 7 of 8

Case #11

Smile restoration with a lower lip muscle and buccinator myectomies performed by Dr. Shai Rozen in Dallas, Texas to restore smile and facial symmetry in addition to Botox®️around the left eye for her blepharospasm secondary to underlying synkinesis. She presented seven months after an event of Bell's Palsy on the let side of the face... Read More

Before and after selective myectomy of the lower lip

PreviousNext

Case: 8 of 8

Case #32

 Smile and lower lip restoration in a patient with synkinesis with myectomy of the lower lip, performed by Dr. Shai Rozen in Dallas, Texas. Patient  presented 4 years after a last event of facial paralysis which was diagnosed as Bell's Palsy and evolved from flaccid facial paralysis to synkinesis. She had difficulty with smiling, ea... Read More

View All Cases

Keep in mind that each patient is unique and your results may vary.

View Photo Gallery Request a Consultation

Treatment Options

The main goal of synkinesis treatment is to rebalance the face. This is often done by weakening excessively strong facial regions and strengthening weak facial regions. Treatment strategies for synkinesis, typically include one or more of the following procedures:

• Selective neurectomies and neurolysis
• Selective myectomies
• BOTOX® injections

Dr. Rozen applies a comprehensive, individualized approach to synkinesis, combining targeted surgical and nonsurgical interventions within a multidisciplinary academic program that addresses both the functional and aesthetic dimensions of the condition.

Dr. Rozen also developed the first comprehensive Patient-Reported Outcome Measures (PROMs) survey to collect information directly from patients about their quality of life and how to better understand patient priorities. 

A Valuable Resource for Those Affected by Facial Paralysis

If you, a loved one, or a patient is affected by facial paralysis, it’s crucial to have accurate, up-to-date information about symptoms and solutions. Board-certified plastic surgeon Dr. Shai Rozen, a specialist in facial paralysis and facial aesthetics, created Your Guide to Facial Paralysis & Bell’s Palsy to be a readily accessible resource for all.

This downloadable, printable e-book makes it easy to understand:

• How paralysis affects the face
• When it’s time to see a specialist
• Common causes of facial paralysis
• The difference between facial paralysis and Bell’s palsy
• Myths and facts
• The latest treatment options
• Answers to common questions

Get your free copy today—to download or view in your web browser—by completing the following fields:

*Required Fields

First Name* Last Name* Email*

I accept the Terms of Use*

By checking the box on the contact form, you agree to the Terms of Use listed here: Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use. By checking this box you hereby agree to hold Shai M. Rozen, M.D., F.A.C.S., its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties.

Download Your Free Copy!

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Reviewed for clinical accuracy by Dr. Shai Rozen on September 15th, 2026.