Evaluating Outcomes of Selective Myectomy of Depressor Anguli Oris, Buccinator, and Platysma in Facial Synkinesis.

[INTRODUCTION] Selective myectomy has gained popularity for treating facial synkinesis.

[OBJECTIVES AND HYPOTHESES] We examined the combined effectiveness of depressor anguli oris (DAO), partial buccinator, and platysma myectomies.

[STUDY DESIGN] Retrospective case series.

[METHODS] Pre- and postoperative botulinum toxin-A (BTX-A) treatments of selective myectomy patients were collected. Facial photographs were analyzed using Emotrics + . Facial Asymmetry Index (FAI) and electronic facial paralysis assessment (eFACE) scores were calculated.

[RESULTS] Twenty patients underwent myectomies. Improvements (mean ± standard error) were seen in several smile metrics, including FAI by 2.80 ± 0.68 mm, nasolabial fold angle by 4.78 ± 1.83 degrees, and smile angle by 4.43 ± 1.18 degrees (all  < 0.05). Postoperative FAI was 2.79 mm. Total BTX-A decreased by 10.85 ± 4.48 units ( = 0.03). eFACE revealed improved oral commissure movement and platysmal synkinesis ( < 0.05 for both).

[CONCLUSION] Combined myectomies of the DAO, partial buccinator, and platysma clinically and statistically improve smile in facial synkinesis.