Injectables for Facial Asymmetry After Injury, Surgery or Illness: A 2026 Review

A 2026 paper in Aesthetic Plastic Surgery looks at the "corrective" patient: someone whose goal is not to look younger, but to restore balance to a face changed by nerve injury, a condition present from birth, cancer surgery or trauma. Despite what the term might suggest, it is not about fixing earlier cosmetic treatments. It reviews how injectables have been used for this group and describes five examples, offering early, low-level evidence that careful, individualized treatment can improve symmetry for some people.

Why this was studied

Most aesthetic research focuses on age-related change: lines, volume loss and skin quality. But a smaller group of people come to clinics because their face is uneven for medical reasons. Examples include facial paralysis after a viral infection such as shingles, weakness present from birth, uneven development of one side of the face, changes after cancer surgery and radiation, or injury from an accident.

Reconstructive surgery and physiotherapy are the main treatments for many of these conditions. The authors wanted to describe how minimally invasive injectables might fit alongside those approaches, and they proposed thinking of these patients as a distinct group with distinct needs.

What the researchers did

This is a descriptive review of published literature, illustrated with five cases treated by the authors. The people described ranged from their early twenties to late fifties. Their concerns included one-sided facial paralysis, abnormal linked muscle movements after nerve injury, uneven facial development, and contour changes after jaw surgery for a tumour.

Treatment used hyaluronic acid filler to rebuild volume and contour on the weaker or smaller side, a hybrid injectable containing both hyaluronic acid and calcium hydroxylapatite in one case, and botulinum toxin type A to relax overactive muscles on the stronger side. Some people had one session, others several over months, and those receiving neuromodulator had repeat treatments roughly every five months over two years.

What they found

The authors report that facial symmetry improved in all five examples, judged from photographs and what the patients said, and that some also showed better balance when moving or smiling. Four had no side effects; one had mild bruising that settled within a week.

From their review of earlier studies, the authors note that side effects of these injectables are usually mild and temporary, but that serious events such as blocked blood flow or vision loss, while rare, are possible with filler. They stress that the dissolving enzyme hyaluronidase should always be available.

How strong is this evidence?

This paper sits low on the evidence scale. A handful of selected cases cannot tell us how often treatment helps, how long results last, or how often problems occur. No standard scoring was used, follow-up varied and every case was different.

It is also important to know that the paper was funded by a company that makes neuromodulator and filler products, and several authors have financial ties to that company. That does not mean the observations are wrong, but it is a reason to read the conclusions cautiously and wait for independent, controlled studies.

What it means for you

If your face is uneven because of a medical condition, injectables may be one tool among several, but they are not a replacement for medical care. The first step is usually assessment by your family doctor and, where appropriate, a specialist such as a neurologist, facial plastic surgeon or physiotherapist with facial rehabilitation training. Some causes of facial weakness need prompt medical treatment, so any new weakness should be seen by a doctor right away, not by an aesthetic clinic.

For longstanding, stable asymmetry, injectables can sometimes help with balance. Neuromodulator can soften overactive muscles on one side, and filler can add support where volume is missing. Results are temporary, need maintenance and vary from person to person. Our articles on neuromodulator for facial asymmetry and filler after facial surgery go into more detail.

Tissue that has been operated on, injured or treated with radiation can behave differently, with scarring and altered blood supply. That makes careful planning, conservative amounts and a clinician who coordinates with your other care providers especially important.

Some people should wait or avoid treatment, including those who are pregnant or breastfeeding, have an active infection near the area, are mid-way through cancer treatment, or have certain nerve or muscle disorders. Common risks include bruising, swelling, temporary unevenness and, rarely, blocked blood flow with filler.

Questions to ask at your consultation

• Has the medical cause of my asymmetry been fully assessed?
• Should my surgeon, oncologist or physiotherapist be involved in the plan?
• What can injectables realistically change, and what can they not?
• How often would maintenance be needed?

Setting realistic expectations

For people with medical asymmetry, the aim is usually improvement rather than perfect symmetry. Every face is naturally a little uneven, and tissue affected by nerve injury, surgery or radiation may respond less predictably. Treatment often works best as a series of small, cautious steps with time to assess each one. It is also reasonable to decide that the risks, cost or upkeep are not worth it, and that is a valid choice.

Frequently asked questions

Can injectables fix facial paralysis?

No. They do not repair nerves. They may improve how balanced the face looks at rest or during movement, alongside medical and rehabilitation care.

Is this the same as correcting a filler result I don't like?

Not quite. This paper focused on medical causes of asymmetry. Correcting a previous cosmetic result is a related but different conversation, often involving dissolving filler first.

Is treatment for medical asymmetry covered by MSI?

Aesthetic injectables are generally not covered. Your family doctor can advise on medically covered options such as specialist referral or rehabilitation.

If you are living with facial asymmetry and wonder whether injectables could play a role, a consultation can help clarify your options and whether a medical referral should come first.

Source

Shturman I, Garzón H, Coimbra D, Villafranca J, Zimbres S, Pyke MdlA, Van Der Graaff I, Dabronzo ML. Minimally invasive aesthetic treatments for the corrective patient archetype: transforming lives. Aesthetic Plastic Surgery, 2026. Read the study