Facial Adipostructuring With Biochemical Modulation in Chronic Peripheral Facial Paralysis: A Case Report

Chronic peripheral facial paralysis (CPFP) implies a prolonged course without recovery of neuromuscular activity of facial expression and the biological impossibility of restoring spontaneous function. Facial paralyses, most commonly idiopathic in origin, are graded using the House-Brackmann (HB) scale, where grade I represents normal function and grades II through VI indicate progressively greater functional compromise. Furthermore, CPFP lacks satisfactory therapeutic options, and conventional strategies, botulinum toxin and surgical reanimation, neither address the collapse of facial structural support nor the dysfunction of dermal white adipose tissue (dWAT) that accompanies chronic denervation. This report presents a treatment strategy for patients with CPFP consisting of Facial Adipostructuring (AEF), a biomechanical reorganization of fat compartments via cannula-based mechanotransduction without tissue extraction, combined with biochemical modulation using dimethylaminoethanol (DMAE), organic silicon, and acetyl hexapeptide-38. The patient progressed from HB grade IV to grade I over three biweekly sessions, with improvement sustained at nine-month follow-up without additional interventions. The changes observed were consistent with improvements on the HB functional scale and were documented through standardized clinical photography. This treatment represents a minimally invasive regenerative approach that may act on the neuro-muscular-adipose unit through dWAT mechanotransduction and neuromuscular junction modulation. We present the case of a female patient with idiopathic facial paralysis of six years' duration, classified as grade IV on the HB scale, who was treated with the described technique.