Introduction: Paralysis of the facial nerve causes functional and psychological disorders because it alters static and dynamic facial symmetry, which is vital for harmonious facial expression.Facial asymmetry and inability to refine facial movements can be caused either by prolonged paralysis, or by the development of postparalytic synkinesis (the loss of the ability to selectively contract a muscle).Clinically, the most common symptoms of synkinesis are either involuntary eye closure with volitional mouth movements (e.g.kiss or blowing), or contraction of zygomaticus and caninus muscles with volitional eye closure.The aim of this study is to assess the effect and efficacy of botulinum toxiu type A (BTX-A) in reducing synkinesis in aberrant facial nerve regeneration (following facial paralysis).Method: BTX-A (Botox(R)) infiltration was performed on patients with synkinesis after facial palsy.Each subject was injected with 2.5 units of BTX-A in each injection site (the sites were chosen on a case-by-case basis).The synkinetic muscles targeted include: orbicularis oculi, depressor labii inferioris, platysma, healthy frontalis.The patients were examined using the Sunnybrook Facial Grading System which assesses resting symmetry, symmetry of voluntary movement, synkinesis., both before the BTX-A treatment and after an average of 20 days.Results: BTX-A treatment resulted in a clinical improvement of static symmetry and a reduction of postparalytic synkinesis.Mean duration of improvement was four months.Conclusions: BTX-A injection treatment was effective in reducing facial synkinesis, thus improving facial expression symmetry both at rest and in voluntary movements.