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Objectives: This presentation aims to outline an injection protocol combining botulinum toxin and hyaluronic acid, designed to enhance facial symmetry and optimize smile dynamics in pregnancy-associated facial palsy. The focus is on demonstrating how the integrated use of these therapies can achieve both functional recovery and aesthetic improvement, ultimately contributing to better quality of life. Introduction: Facial nerve palsy causes unilateral weakness or paralysis from seventh cranial nerve injury. Incidence is increased during pregnancy, with a threefold higher risk. While most cases are idiopathic and self-limiting, persistent deficits beyond four weeks require specialized care. Treatment is challenging in pregnancy due to limited safe therapeutic options. Materials / method: A 38-year-old woman, 38 weeks pregnant, with a history of Hashimoto’s thyroiditis, presented with left peripheral facial palsy unresponsive to corticosteroid therapy. At seven months postpartum, she developed synkinesis and spasms, with limited response to supportive therapies and localized botulinum toxin. She was subsequently treated using a personalized protocol consisting of full-face and neck botulinum toxin injections combined with hyaluronic acid fillers, aiming for facial symmetrisation and dynamic smile optimization. Results: Repeated treatment sessions led to progressive improvement in both facial function and aesthetics, with reduction of spasms, better smile dynamics, and overall facial balance. Beyond clinical outcomes, the therapeutic approach improved the patient’s quality of life, enabling her to resume professional activity with restored self-confidence. Conclusion: Persistent facial palsy in pregnancy requires multidisciplinary care, but therapeutic options are limited and evidence scarce. This case is notable for the combined use of botulinum toxin and hyaluronic acid—beyond the usual botulinum toxin monotherapy—demonstrating functional and aesthetic improvement with significant quality-of-life benefit.