What is DAO resection for facial paralysis?
A DAO resection, or “smile release,” is a minor office procedure indicated to improve smile symmetry in patients with facial synkinesis. The depressor anguli oris (DAO) muscle is a fan-shaped muscle that pulls down on the corner of the mouth and “tethers” the smile in synkinesis patients due to an excess of tone. Numerous studies have demonstrated that removal of this muscle improves excursion of or the oral commissure and improves smile symmetry in up to 89% of synkinesis patients. The goal is to provide a subtle lift to the corner of the mouth on the affected side.
Is DAO resection covered by insurance?
Yes, this procedure is covered by insurance for the indication of facial synkinesis.
What can I expect at my appointment?
This procedure is performed in the procedure clinic under local anesthesia. On the day of your appointment, you will have a chance to meet with a team member to ask any questions and sign the necessary paperwork. You will be positioned comfortably, and the lower lip will be numbed with a small lidocaine injection. The DAO muscle is accessed through a small incision in the inside of the cheek; there are no external incisions or scars. Once the muscle is removed, several dissolving stitches are placed. Botox can be administered on the same day, if indicated. The entire appointment typically takes less than 1 hour. You are welcome to bring a support person to the appointment, but if you prefer to come alone you are able to drive yourself home from the appointment.
What can I expect after the procedure?
The numbing medication will last for 1.5 to 2 hours. After the numbing medication wears off, we suggest eating a soft diet (ice cream, yogurt, pudding, etc.) for the rest of the day, then resuming a normal diet the following day. A small amount of bruising and/or swelling is expected. Applying ice and sleeping with a few pillows behind your head will help to decrease the swelling. Most patients describe the pain as feeling sore and find relief by taking Tylenol and Ibuprofen. The dissolving stitches can take anywhere from 10-21 days to fully dissolve.
When can I expect to see results?
For most patients, results are evident 4-6 weeks following the procedure.
