Role of Hyaluronic Acid Fillers in Facial Paralysis.
6 affiliations
- 1From the Faculty of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
- 2Faculty of Medicine, University of Mouloud Maameri, Tizi Ouzou, Algeria.
- 3Faculty of Medicine, University of Balamand, Beirut, Lebanon.
- 4Brain Function Research Group, Department of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
- 5Department of Dermatology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil.
- 6Department of Plastic and Reconstructive Surgery, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil.
Abstract
Background
Facial paralysis results in multifaceted functional and aesthetic deficits, including lagophthalmos, oral incompetence, and profound asymmetry. Although surgical reanimation is the primary treatment for functional restoration, hyaluronic acid (HA) fillers have emerged as a minimally invasive adjunctive tool for soft-tissue support and aesthetic refinement.Methods
A comprehensive narrative review was conducted using PubMed, Embase, Scopus, and the Cochrane Library databases through November 15, 2025. This study follows the rigorous methodological framework for narrative synthesis, emphasizing clarity of scope, reflexivity, and thematic sufficiency. Studies evaluating HA fillers for lagophthalmos, oral competence, and facial symmetry were analyzed.Results
Data from prospective and retrospective studies indicate that HA fillers can notably improve lagophthalmos by providing mechanical lid loading, reducing residual gaps from an average of 5.5 to 0.8 mm. In the perioral region, HA injections have been shown to increase labial strength by 1.4-fold, reducing bolus spillage and improving speech articulation. Patient-reported outcomes show substantial improvements in psychosocial distress (P < 0.0001) and quality of life. However, evidence for neuromuscular recovery is absent, and there is a documented risk of vascular complications, including central retinal artery occlusion.Conclusions
HA fillers provide immediate mechanical and aesthetic benefits as an adjunctive treatment for facial paralysis and should be considered complementary to surgical interventions where indicated; however, they do not restore nerve function and cannot replace surgery. Future research must focus on standardized protocols and the long-term safety of periorbital injections.
Related
- Malar Edema after Hyaluronic Acid Dermal Fillers: Expert Recommendations on Etiology, Prevention, and Management
- Efficacy, Durability, and Safety of VYC‐17.5L Hyaluronic Acid Dermal Filler for Facial Enhancement: A Systematic Review and Single‐Arm Meta‐Analysis
- Efficacy of Kinesio tape for central facial paralysis : A prospective, randomized sham-controlled, single-blinded clinical trial
- Explainable deep graph attention learning with enhanced residual SwinV2 transformer for interpretable facial paralysis severity assessment
- Local Administration of Insulin‐Like Growth Factor 1 Attenuates Neuronal Loss and Muscle Atrophy in a Guinea Pig Model of Severe Facial Paralysis
BibTeX
@article{iqbal2026role,
title = {{Role of Hyaluronic Acid Fillers in Facial Paralysis.}},
author = {Minahil Iqbal and Amina Berour and Macram Wakim and Zuha Ajlan and Nancy Emmanuel and Gregory Nicolas and Juan P Menéndez},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008089},
url = {https://europepmc.org/article/MED/42921614},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Role of Hyaluronic Acid Fillers in Facial Paralysis.
AU - Minahil Iqbal
AU - Amina Berour
AU - Macram Wakim
AU - Zuha Ajlan
AU - Nancy Emmanuel
AU - Gregory Nicolas
AU - Juan P Menéndez
PY - 2026
DA - 2026/10/23
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008089
UR - https://europepmc.org/article/MED/42921614
AB - Background Facial paralysis results in multifaceted functional and aesthetic deficits, including lagophthalmos, oral incompetence, and profound asymmetry. Although surgical reanimation is the primary treatment for functional restoration, hyaluronic acid (HA) fillers have emerged as a minimally invasive adjunctive tool for soft-tissue support and aesthetic refinement.Methods A comprehensive narrative review was conducted using PubMed, Embase, Scopus, and the Cochrane Library databases through November 15, 2025. This study follows the rigorous methodological framework for narrative synthesis, emphasizing clarity of scope, reflexivity, and thematic sufficiency. Studies evaluating HA fillers for lagophthalmos, oral competence, and facial symmetry were analyzed.Results Data from prospective and retrospective studies indicate that HA fillers can notably improve lagophthalmos by providing mechanical lid loading, reducing residual gaps from an average of 5.5 to 0.8 mm. In the perioral region, HA injections have been shown to increase labial strength by 1.4-fold, reducing bolus spillage and improving speech articulation. Patient-reported outcomes show substantial improvements in psychosocial distress (P < 0.0001) and quality of life. However, evidence for neuromuscular recovery is absent, and there is a documented risk of vascular complications, including central retinal artery occlusion.Conclusions HA fillers provide immediate mechanical and aesthetic benefits as an adjunctive treatment for facial paralysis and should be considered complementary to surgical interventions where indicated; however, they do not restore nerve function and cannot replace surgery. Future research must focus on standardized protocols and the long-term safety of periorbital injections.
SN - 2169-7574
ER -