DAO Muscle Problem in Baby

is it possible to correct a DAO muscle problem in a baby? if not at what age is best for the little one?

Doctor Answers 3

The crooked smile (DAO muscle problem) in a baby: surgical and non-surgical options

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The treatment depends on cause of the DAO problem. Occasionally temporary causes such as a crush injury from forceps or positioning. In these cases, it may resolve on its own. When it is congenital and permanent there are a few options. The most popular is to inject the opposite and normal DAO to weaken it and cause a more symmetric smile. The surgical alternative is to transfer the anterior belly of the digastric muscle to the corner of the mouth. 

Botox for infant

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If your baby had a nerve problem so the DAO muscle is not working on one side, then when the normal side works it pulls the corner of the lip down looking very uneven. If Botox were injected in the normal side then it becomes immobile and the appearance becomes more normal but function is compromised such as not opening wide to eat off a spoon and possibly a problem with latching on during nursing. As B otox has not been studied in children it would be an off-label use and you would need to consult with a neurologist and preferably a pediatric neurologist.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

"DAO muscle problem" in baby

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Regarding :"is it possible to correct a DAO muscle problem in a baby? if not at what age is best for the little one?"

Not quite sure what you are referring to. In days gone by when the forceps was commonly used in deliveries, there was a much higher incidence of Facial Nerve weakness and especially to the DAO caused by compression of the inferior branch of the nerve as it came out of the opening of the skull just below the ear. It is said that action movie star Sylvester Stallone's asymmetric smile may be the result of such a forceps injury. If this is what you are referring to, I am not sure that there is a solution. You should consult a Pediatric Neurologist, not Plastic surgeons for help with this issue.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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