Manipulating facial musculature surgically?

Question

Often I wonder why some people's facial expressions differ sometimes regardless that we all have the same set of muscles. I still don't know exactly why for example some people's lip corner turn upwards when smiling while others just go sideways, I'm guessing it has something to do with variations in muscle insertions around the perioral region. Which made me wonder whether mimetic muscles can be manipulated surgically someohow, surely doctors have dabbled with that at some point?

Adrian E. House, MD, FACS · Answer

You raise an interesting point. The variations in facial expressions can indeed be attributed to a combination of factors, including muscle insertions and nerve control. While the basic muscle structure is consistent, the way those muscles are controlled by nerves can differ among individuals.
In some cases, certain facial muscles might be selectively modified by reducing or rerouting nerve input (called a selective neurectomy). This involves targeting specific nerves that control muscles responsible for particular expressions. This approach allows for more precise control over facial movement while preserving natural expressions. Additionally, for muscles like the DAO and platysma, there is potential for reduction or removal, although this is less commonly performed due to its unpredictability.

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