from mime therapy are stable one year after therapy. current mime therapy consists of a combination of procedures designed to promote symmetry of the face at rest and during movement to control synkinesis. the components include: massage, stretching exercises, exercises to coordinate both halves of the face, etc. the overall aim of mime therapy is to develop a conscious connection between the use of facial muscles and emotional expression. while facial retraining therapy is more focused on treating slight synkinetic movements, mime therapy aims to increase the overall vigor of the muscles through active exercises, while in the process of doing so, teaching the face to decrease unwanted synkinetic movements. botox botox (botulinum toxin) is a new and versatile tool for the treatment of synkinesis. initially used for reducing hyperkinesis after facial palsy, botox was later attempted on patients with post-facial palsy synkinesis to reduce unwanted movements. the effects of botox have shown to be remarkable, with synkinetic symptoms disappearing within 2 or 3 days. the most common treatment targets are the orbicularis oculi, depressor anguli oris (dao), mentalis, platysma and the contralateral depressor labii inferioris muscles. due to the short span of botox effects though, patients must come back to the doctor for re-injection approximately every 3 months. more notable is that in a majority of patients, various synkinetic movements completely disappeared after 2-3 sessions of trimonthly botox injections. a more specific synkinesis, crocodile tears syndrome (hyperlacrimation upon eating), has been shown to respond exceedingly well to botox injection. botox is injected directly into the lacrimal gland and has shown to reduce hyperlacrimation within 24–48 hours. the procedure was shown to be simple and safe with very little chance of side-effects (although on rare occasions ptosis can occur due to botulinum toxin diffusion). furthermore, reduction in hyper-lacrimation was shown to last longer than the expected 3 months (about 12 months). since botox can mimic facial paralysis, an optimized dose has been determined that reduces involuntary synkinesis of the muscle while not affecting muscle tone. surgery practical surgical procedures used for treating synkinesis are neurolysis and selective myectomy. neurolysis has been shown to be effective in relieving synkinesis but only temporarily and unfortunately symptoms return much worse than originally. selective myectomy, in which a synkinetic muscle is selectively resected, is a much more effective technique that can provide permanent relief and results in a low recurrence rate; post-operative complications may include edema, hematoma, and ecchymosis.