Facial paresis involves partial paralysis. It can affect all the muscles of the mid-face or just one region: the most frequently affected is the lower lip. It may also be evident at the level of the upper lip or forehead.
The main causes are incomplete functional recovery after Bell’s palsy and partial recovery after trauma, cranial base surgery, or parotid surgery. Sometimes the defect is present at birth: so-called congenital paresis.

Paresis manifests very little at rest. Only a trained eye may detect signs, consisting primarily of a reduction in the depth of fine creases and natural skin folds. It is essential to make a comparative study between the two sides of the face to detect these small asymmetries.
Paresis is more evident during facial expressions. Thus, a smile or eyebrow elevation can be helpful in revealing it. Several corrective surgeries may limit its effects.

Clinical case

Middle-grade asymmetry of the upper lip at rest.

BEFORE
Middle-grade asymmetry of the upper lip at rest.

The deficit was corrected well after surgery.

AFTER
The deficit was corrected well after surgery.

Lip motility deficit with lip dragging towards the left is evident when smiling.

BEFORE
Lip motility deficit with lip dragging towards the left is evident when smiling.

The deficit was corrected well after surgery.

AFTER
The deficit was corrected well after surgery.

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Clinical case

Mild asymmetry of the upper lip at rest.

BEFORE
Mild asymmetry of the upper lip at rest.

Resolution of the defect after surgery.

AFTER
Resolution of the defect after surgery.

The paresis was more evident during smiling at the upper lip level, and less at the lower lip.

BEFORE
The paresis was more evident during smiling at the upper lip level, and less at the lower lip.

The defect was corrected well after surgery.

AFTER
The defect was corrected well after surgery.

Clinical case

Medium-grade asymmetry of the upper lip at rest.

BEFORE
Medium-grade asymmetry of the upper lip at rest.

Symmetry of the face after surgery.

AFTER
Symmetry of the face after surgery.

Paresis was centred primarily on the upper lip during smiling.

BEFORE
Paresis was centred primarily on the upper lip during smiling.

The defect was barely visible after surgery.

AFTER
The defect was barely visible after surgery.