{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:40:07Z","timestamp":1792118407166,"version":"4.4.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:p>Management of post-facial paralysis synkinesis has evolved for the past decade with diversification of neuromuscular retraining, chemodenervation, and advanced surgical reanimation techniques. Chemodenervation with botulinum toxin-A is a commonly used treatment modality for synkinesis patients. Treatment has shifted from solely weakening the unaffected contralateral facial musculature for rote symmetry to selective reduction of undesired or overactive synkinetic muscles, allowing for a more organized motion of the recovered musculature. Facial neuromuscular retraining should be considered a crucial component of treating patients with synkinesis along with soft tissue mobilization, but specifics of these are beyond the scope of this article. Our goal was to create a descriptive platform for our method of chemodenervation treatment in the evolving field of post-facial paralysis synkinesis. A multi-institutional and multidisciplinary comparison of techniques was performed with photograph and video creation, review, and discussion over an electronic platform with all authors. Anatomic specifics of each region of the face and individual muscles were considered. A muscle by muscle algorithm for synkinesis therapy was created to include chemodenervation with botulinum toxin that should be considered for patients suffering from post-facial paralysis synkinesis.<\/jats:p>","DOI":"10.1089\/fpsam.2022.0206","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T14:56:11Z","timestamp":1685458571000},"page":"512-518","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Chemodenervation Algorithm: Functional and Aesthetic Considerations for Facial Harmony in Patients with Post-Facial Paralysis Synkinesis"],"prefix":"10.1177","volume":"25","author":[{"given":"Laura","family":"Hetzler","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."},{"name":"Center for Facial Nerve Disorders, Baton Rouge, Louisiana, Our Lady of The Lake Regional Medical Center, Baton Rouge, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"MacDowell","sequence":"additional","affiliation":[{"name":"Center for Facial Nerve Disorders, Baton Rouge, Louisiana, Our Lady of The Lake Regional Medical Center, Baton Rouge, Louisiana, USA."},{"name":"Department of Physical Therapy, Louisiana State University, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Diels","sequence":"additional","affiliation":[{"name":"Facial Retraining LLC, Formerly of University of Wisconsin, Madison, Wisconsin, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5071-2239","authenticated-orcid":false,"given":"Tracy","family":"VandeWater","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5607-1022","authenticated-orcid":false,"given":"Babak","family":"Azzizadeh","sequence":"additional","affiliation":[{"name":"Facial Plastics and Reconstructive Surgery, The Facial Paralysis Institute, Beverly Hills, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.9.4.234"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31820e9138"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2013.2463"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005590"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000008154"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199612000-00009"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1075840"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22404"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199305000-00011"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0610"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001406"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0462"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007674"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007593"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0009"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfacial.2011.43"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.12703\/P5-49"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2021.03.005"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2003.12.026"},{"issue":"77","key":"e_1_3_5_21_2","first-page":"251","article-title":"Management of synkinesis and asymmetry in facial nerve palsy: a review article","volume":"26","author":"Pourmomeny AA","year":"2014","unstructured":"Pourmomeny AA, , Asadi S. 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