Resumo

Objectives: To use fillers and botulinum toxin to treat facial asymmetries of neurological patients Introduction: The art of treating facial deformities due to accidents, neurological conditions, burns, or other conditions is an evolving field of medicine since these deformities have a negative impact on the quality of life, work life, and social life. Those conditions can receive non-surgical treatments with the collaboration of different multidisciplinary healthcare professionals. A combination of pharmacological treatments such as botulinum toxin and fillers or polynucleotides seems like an optimal solution, taking into consideration both the static and dynamic aspects of facial expression. Materials / method: A 41-year-old female patient with a traumatic peripheral facial nerve palsy after an operation on her right ear during her childhood came to our outpatient clinic. She had a dynamic asymmetry, especially when she was smiling. Her medical history revealed that she has undergone, over the last 15 years, several BONT-A treatments and filler applications. The patient was treated with injections of BoNTA-ABO (230 units) and with 2 ml of hyaluronic acid dermal filler in order to restore the asymmetries of her face. Results: The patient was assessed 5 weeks after the injections, and she had a remarkable improvement in her dynamic asymmetry, especially when smiling. The patient readmitted 7 weeks after the first treatment, and she was injected with 3 ml of hyaluronic acid dermal filler in order to further restore the midface volume of her face. Conclusion: The combination of injectables could be a safe and effective therapy for the restoration of asymmetries due to facial nerve palsy. Long and frequent sessions of treatment are suggested. We hope our case report will prompt other clinicians to use the proposed combination of injectables.