{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:06:20Z","timestamp":1783983980747,"version":"3.55.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Selective myectomy has gained popularity for treating facial synkinesis.<\/jats:p>\n                  <jats:p>We examined the combined effectiveness of depressor anguli oris (DAO), partial buccinator, and platysma myectomies.<\/jats:p>\n                  <jats:p>Retrospective case series.<\/jats:p>\n                  <jats:p>Pre- and postoperative botulinum toxin-A (BTX-A) treatments of selective myectomy patients were collected. Facial photographs were analyzed using Emotrics\u2009+\u2009. Facial Asymmetry Index (FAI) and electronic facial paralysis assessment (eFACE) scores were calculated.<\/jats:p>\n                  <jats:p>Twenty patients underwent myectomies. Improvements (mean\u2009\u00b1\u2009standard error) were seen in several smile metrics, including FAI by 2.80\u2009\u00b1\u20090.68\u2009mm, nasolabial fold angle by 4.78\u2009\u00b1\u20091.83\u2009degrees, and smile angle by 4.43\u2009\u00b1\u20091.18\u2009degrees (all p\u2009&lt;\u20090.05). Postoperative FAI was 2.79\u2009mm. Total BTX-A decreased by 10.85\u2009\u00b1\u20094.48 units (p\u2009=\u20090.03). eFACE revealed improved oral commissure movement and platysmal synkinesis (p\u2009&lt;\u20090.05 for both).<\/jats:p>\n                  <jats:p>Combined myectomies of the DAO, partial buccinator, and platysma clinically and statistically improve smile in facial synkinesis.<\/jats:p>","DOI":"10.1055\/a-2741-2508","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T23:58:27Z","timestamp":1762559907000},"page":"517-523","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Outcomes of Selective Myectomy of Depressor Anguli Oris, Buccinator, and Platysma in Facial Synkinesis"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4540-8891","authenticated-orcid":false,"given":"Elise","family":"Krippaehne","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-7892","authenticated-orcid":false,"given":"Bastien A.","family":"Valencia-Sanchez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-7850","authenticated-orcid":false,"given":"Murray J.","family":"Bartho","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-7168","authenticated-orcid":false,"given":"Kayva","family":"Crawford","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-7054","authenticated-orcid":false,"given":"Myriam","family":"Loyo","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1019554","DOI":"10.3389\/fneur.2022.1019554","article-title":"Pathogenesis, diagnosis and therapy of facial synkinesis: a systematic review and clinical practice recommendations by the International Head and Neck Scientific Group","volume":"13","author":"O Guntinas-Lichius","year":"2022","journal-title":"Front Neurol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/MOO.0000000000000376","article-title":"Latest advances in the management of facial synkinesis","volume":"25","author":"J D Markey","year":"2017","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/coa.12799","article-title":"Synkinesis in Bell's palsy in a randomised controlled trial","volume":"42","author":"N Bylund","year":"2017","journal-title":"Clin Otolaryngol"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1097\/PRS.0000000000001802","article-title":"Epidemiologic overview of synkinesis in 353 patients with longstanding facial paralysis under treatment with botulinum toxin for 11 years","volume":"136","author":"A G Salles","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/PHM.0000000000001840","article-title":"Botulinum toxin type A injection in the treatment of postparetic facial synkinesis: an integrative review","volume":"101","author":"H Tavares","year":"2022","journal-title":"Am J Phys Med Rehabil"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1089\/fpsam.2020.0009","article-title":"Beyond botox: contemporary management of nonflaccid facial palsy","volume":"22","author":"M Q Miller","year":"2020","journal-title":"Facial Plast Surg Aesthet Med"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/PRS.0000000000007674","article-title":"The effect of depressor anguli oris muscle block on facial symmetry in synkinetic facial paralysis patients and its role in preoperative assessment","volume":"147","author":"A E Krag","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1001\/jamafacial.2016.1115","article-title":"Effect of weakening of ipsilateral depressor anguli oris on smile symmetry in postparalysis facial palsy","volume":"19","author":"N Jowett","year":"2017","journal-title":"JAMA Facial Plast Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.bjps.2023.08.006","article-title":"Botulinum toxin treatment of the buccinator muscle facial synkinesis: a systematic review","volume":"86","author":"F W de Jongh","year":"2023","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/j.bjps.2020.12.002","article-title":"Buccinator synkinesis treated by botulinum toxin in facial palsy and hemifacial spasms","volume":"74","author":"M Kanerva","year":"2021","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1093\/asj\/sjad148","article-title":"The functional anatomy and innervation of the platysma is segmental: Implications for lower lip dysfunction, recurrent platysmal bands, and surgical rejuvenation","volume":"43","author":"L Minelli","year":"2023","journal-title":"Aesthet Surg J"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1002\/lary.24732","article-title":"Platysma synkinesis in facial palsy and botulinum toxin type A","volume":"124","author":"A 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A single-cohort comparison in postparetic facial synkinesis","volume":"150","author":"A S Hembd","year":"2022","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/00005537-200103000-00005","article-title":"Validation of a patient-graded instrument for facial nerve paralysis: the FaCE scale","volume":"111","author":"J B Kahn","year":"2001","journal-title":"Laryngoscope"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1097\/MLG.0b013e3180412460","article-title":"Validation of the synkinesis assessment questionnaire","volume":"117","author":"R P Mehta","year":"2007","journal-title":"Laryngoscope"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1001\/jamafacial.2018.0030","article-title":"A machine learning approach for automated facial measurements in facial palsy","volume":"20","author":"D L Guarin","year":"2018","journal-title":"JAMA Facial Plast Surg"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1001\/jamafacial.2018.0048","article-title":"The multivector gracilis free functional muscle flap for facial reanimation","volume":"20","author":"K O Boahene","year":"2018","journal-title":"JAMA Facial Plast Surg"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1001\/jamafacial.2015.1558","article-title":"Early nerve grafting for facial paralysis after cerebellopontine angle tumor resection with preserved facial nerve continuity","volume":"18","author":"M Albathi","year":"2016","journal-title":"JAMA Facial Plast Surg"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"223e","DOI":"10.1097\/PRS.0000000000001447","article-title":"Clinician-graded electronic facial paralysis assessment: the eFACE","volume":"136","author":"C A Banks","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"261e","DOI":"10.1097\/PRS.0000000000008807","article-title":"Releasing the smile: depressor anguli oris excision in the context of managing nonflaccid facial palsy","volume":"149","author":"A Derakhshan","year":"2022","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1089\/fpsam.2023.0160","article-title":"Outcomes following depressor anguli oris myectomy in nonflaccid facial palsy: a review","volume":"26","author":"N G DeSisto","year":"2024","journal-title":"Facial Plast Surg Aesthet Med"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1001\/archfaci.2010.101","article-title":"Threshold of visual perception of facial asymmetry in a facial paralysis model","volume":"13","author":"E A Chu","year":"2011","journal-title":"Arch Facial Plast Surg"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1001\/archfacial.2011.43","article-title":"Platysmectomy: an effective intervention for facial synkinesis and hypertonicity","volume":"13","author":"D K Henstrom","year":"2011","journal-title":"Arch Facial Plast Surg"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/PRS.0000000000011042","article-title":"Selective myectomies alone versus selective myectomies combined with neurectomies in postparetic synkinesis: comparing outcomes","volume":"154","author":"C V Sanchez","year":"2024","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/asj\/sjy150","article-title":"Cervical branch of facial nerve: an explanation for recurrent platysma bands following necklift and platysmaplasty","volume":"39","author":"S Sinno","year":"2019","journal-title":"Aesthet Surg J"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/PRS.0000000000002604","article-title":"Complete platysma transection in neck rejuvenation: a critical appraisal","volume":"138","author":"M Pelle-Ceravolo","year":"2016","journal-title":"Plast Reconstr Surg"}],"container-title":["Facial Plastic 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